Off-pump Coronary Artery Bypass Grafting in BMA Medical College and Vajira Hospital
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Date
2010-01-13
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Vajira Medical Journal
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Abstract Off-pump Coronary Artery Bypass Grafting in BMA Medical College and Vajira Hospital Suksan Kanoksin MD, FICST* Suphakarn Techapongsatorn MD, FICST* Petchsree Charoensombatamorn BS (nursing)** Siriwan Tankittiwat BN, MSc (nursing administration)** * Department of Surgery, BMA Medical College and Vajira Hospital ** Nursing Department, BMA Medical College and Vajira Hospital Objective: To compare the results between off-pump and on-pump coronary artery bypass grafting. Study design: Cross-sectional study. Subjects: A total of sixty-two patients with coronary heart disease underwent coronary bypass at the Department of Surgery, Bangkok Metropolitan Administrtion Medical College and Vajira Hospital during November 2003 to April 2005 were enrolled. Methods: Hospital records and operative note records were collected and analyzed. Main outcome measures: Preoperative risk factors, intra-operative clinical markers and postoperative outcomes. Results: From the study, the differences between both groups in terms of age, sex, blood pressure, hyperlipidemia and diabetic mellitus were not significant. But there were statistically significant differences between both groups in terms of chronic obstructive pulmonary disease, renal disease, heart failure and number of vessel disease. According to result from intraoperative clinical markers, there was statistically significant differences between both groups in terms of numbers of bypass grafts. From the result of postoperative outcomes, on-pump coronary artery bypass group had more mortality rate, stroke incidence, wound infection rate, reoperation rate for stop bleeding, blood transfusion, drainage volume, rising of cardiac enzyme, longer period of ICU stay, longer ventilator dependence period, and longer hospital admission period. Conclusion: The outcomes of off-pump coronary artery bypass grafting was better than on-pump coronary artery bypass grafting for treatment of coronary heart disease patients. This procedure can reduce the post-operative blood transfusion, post-operative ventilation usage, post-operative ICU stay, and hospital stay. Vajira Med J 2007 ; 51 : 171 - 177
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Vajira Medical Journal; Vol. 51 No. 3 September - December 2007; 171-177