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The feasibility and safety of off-pump coronary bypass surgery in emergency revascularization

  
@article{JTD20715,
	author = {Hyun-Chel Joo and Young-Nam Youn and Byung-Chul Chang and Kyung-Jong Yoo},
	title = {The feasibility and safety of off-pump coronary bypass surgery in emergency revascularization},
	journal = {Journal of Thoracic Disease},
	volume = {10},
	number = {4},
	year = {2018},
	keywords = {},
	abstract = {Background: The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) in emergency revascularization remains controversial despite its widespread use. The aim of our study was to examine the applicability and safety of OPCAB in patients who were indicated for emergency surgery.
Methods: This single-center study reviewed the indication, operative data, and early and long-term outcomes of 113 patients (mean age, 67.2±9.0 years; logistic EuroSCORE, 14.3±13.5) who underwent emergency OPCAB from January 2003 to December 2014 and were followed up (94.6% completion rate) for a mean 51.1±40.3 (range, 1–135) months. 
Results: Emergency OPCAB was associated with favorable surgical outcomes (number of distal anastomoses per patient, 3.04±0.87; internal thoracic artery (IMA) use, 98.2%; complete revascularization, 79.6%) and  in-hospital outcomes (mortality, 5.3%; low cardiac output syndrome, 5.3%; stroke, 2.7%; pulmonary complications, 8.8%; renal failure, 11.5%). Only five patients (4.4%) required on-pump conversion. The 10-year outcomes were also acceptable (survival, 75.4%±5.6%; major cerebral and cardiovascular events, 52.1%±1.8%). The multivariate risk factors for late mortality were peripheral vascular disease (HR 2.95, 95% CI: 1.11–11.83), cardiogenic shock (HR 3.67, 95% CI: 1.35–9.96), and incomplete revascularization (HR 3.41, 95% CI: 1.06–14.26). When patients were separated by whether the procedure was performed early (},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/20715}
}