Journal of cardiac surgery
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Comparative Study
Effect of aprotinin on postoperative blood loss in off-pump coronary artery bypass surgery.
Off-pump coronary artery bypass (OPCAB) enables a reduction in postoperative complications, particularly bleeding and transfusion. Nevertheless, a significant percentage of patients still needs transfusion. The effect of antifibrinolytic therapy on postoperative bleeding as part of OPCAB is still not widely described. The purpose of this study was to investigate the potential benefit of aprotinin in OPCAB. ⋯ Aprotinin significantly reduced postoperative blood loss without reducing the transfusion rate. Aprotinin was not associated with any increase in postoperative complications.
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Comparative Study
Predictors of mid-term symptom recurrence, adverse cardiac events and mortality in 591 unselected off-pump coronary artery bypass graft patients.
Off-pump coronary artery bypass (OPCAB) grafting is gaining popularity; however, decreased mid-term graft patency and increased coronary reintervention rates are reported. ⋯ OPCAB grafting can be performed with low symptom recurrence, adverse cardiac events, and mortality rates. Modification of intra- and postoperative management strategies may improve outcomes.
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Comparative Study
Elective intraaortic balloon counterpulsation in high-risk off-pump coronary artery bypass grafting.
The beneficial effects of intraaortic balloon pump (IABP) in CABG with cardiopulmonary bypass (CPB) have been reported. However, the benefits of insertion of IABP electively in high-risk off-pump coronary artery bypass grafting (OPCAB) have not been established. Six hundred and twenty-five patients who underwent OPCAB form the study group. ⋯ There was no difference in mortality between the two groups (n = 1 in each group). In high-risk patients undergoing OPCAB, routine preoperative insertion of IABP electively reduces the incidence of acute renal failure. In addition it avoids the need for emergency insertion postoperatively and may result in earlier discharge.