Off-Pump Coronary Artery-Bypass Grafting (OPCAB) at Sudan Heart Institute : Is it A Safe Operation for Coronary Revascularization in Sudan?

blue candle 13

Authors

blue candle 13

Keywords:

CABG, OPCAB, SHI, sudan

Abstract

Background: The incidence of coronary artery disease (CAD) is rising in Sudan as well as in Africa and all over the world, with increasing need for myocardial revascularization. This study is an attempt to highlight the safety of practicing off- pump coronary artery bypass grafting as a primary option for surgical myocardial revascularization, as the use of cardiopulmonary bypass machine was found to be associated with many cardiovascular and systemic complications. Lacking local information regarding this operation dedicated the need to structure such a research in order to be a basis for further studies. Objective: To assess the preoperative characteristics and outcome of patients undergoing off-pump coronary artery bypass surgery. Method: This is a combined retro-prospective descriptive consecutive case series study conducted at Sudan Heart Institute (SHI) and included all the patients with CAD; who were candidates for CABG; presented in the period between Aug/2011 to Aug/2013 Results: 91 patients were included in this study. Females (30.8%) were less affected compared to males and the most affected age group was 41-69 years. 63.7% had HTN, 52.7% had DM. The majority (76.9%) presented with angina CCS class III or VI. Significant LM coronary artery disease was detected in 38 (41.8%). None of the patients had post operative MI. 10 (11.0%) patients developed atrial fibrillation. 56 (61.5%) were extubated within the first 6 hours and 61 (67%) needed primary ICU care for one or 2 days. One death (1.1%) was reported during 30 days- postoperative follow up. Conclusion: Off-pump coronary artery bypass grafting could be conducted safely in SHI with reasonable outcome compared to the international data.

Downloads

How to Cite

Off-Pump Coronary Artery-Bypass Grafting (OPCAB) at Sudan Heart Institute : Is it A Safe Operation for Coronary Revascularization in Sudan?. (2014). Global Journal of Medical Research, 14(4), 29-34. https://medicalresearchjournal.org/index.php/GJMR/article/view/

Download Citation

References

Goetz RH, Rohman M, Haller JD (1961) INTERNAL MAMMARY-CORONARY ARTERY ANASTOMOSIS. 41(3), 378-386. https://doi.org/10.1016/s0022-5223(20)31701-3

V. Kolessov (1967) Mammary artery-coronary artery anastomosis as method of treatment for angina pectoris. 54(4), 535-544. https://doi.org/10.1016/s0022-5223(19)43061-4

J. Gibbon (1954) Application of a mechanical heart and lung apparatus to cardiac surgery. 37, 171-180.

Benetti Fl, G. Naselli, M. Wood, L. Geffner (1991) Direct myocardial revascularization without extracorporeal circulation. Experience in 700 patients. 1003, 312-316.

Buffolo E, Andrade JCS, Succi JE (1985) Direct myocardial revascularization without cardiopulmonary bypass Thorac Cardiovasc Surg 1985. 6(01), 26-29. https://doi.org/10.1055/s-2007-1014076

K. Akiyama, K. Ogasawara, T. Inoue, S. Shindou, H. Okumura, N. Negishi, Y. Sezai (1999) Myocardial revascularization without cardiopulmonary bypass in patients with operative risk factors. 5, 31-35.

T. Tashiro, K. Todo, Y. Haruta, H. Yasunaga, Y. Tachikawa (1996) Coronary Artery Bypass Grafting without Cardiopulmonary Bypass for High-Risk Patients. 4(2), 207-211. https://doi.org/10.1177/096721099600400218

Taro Yokoyama, Fritz Baumgartner, Ali Gheissari, Eli Capouya, George Panagiotides, Richard Declusin (2000) Off-pump versus on-pump coronary bypass in high-risk subgroups. 70(5), 1546-1550. https://doi.org/10.1016/s0003-4975(00)01922-6

Edvin Prifti, Massimo Bonacchi, Gabriele Giunti, Giacomo Frati, Piero Proietti, Marzia Leacche, Andrea Salica, Guido Sani, Gianluca Brancaccio (2000) Does On-Pump/Beating-Heart Coronary Artery Bypass Grafting Offer Better Outcome in End-Stage Coronary Artery Disease Patients?. 15(6), 403-410. https://doi.org/10.1111/j.1540-8191.2000.tb01300.x

Khail S, Ibrahim-Khalil M, El M (1996) Coronary event rates in Khartoum, Sudan.J Clinic Epidemiol 1996:. 9, 1013-1010.

World Expectancy (2011) Coronary Heart Disease in Sudan. http://www.worldlifeexpectancy.com/sudan-coronary-heart-disease

N. Elhassen, SHI experience (2011) Sudan association of surgeons' conference.

M. Gwozdziewicz, P. Olsak, V. Lonsky, M. Elfmark (2008) The choice of on- or offpump coronary bypass grafting- a surgeon dilemma. 152(2), 289-292.

Salah Eldien (2009) Pitfalls in Off-Pump Coronary Artery Bypass Surgery. 31(3), 135-145.

Angelini GD, Taylor FC, Reeves BC, Ascione R (2002) Early and midterm outcome after off-pump and on-pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. 359, 1194-1199.

Goss Aldea GS, Quinton Boyle EM Jr, Maynard C (2003) Use of Off-Pump and On-Pump CABG Strategies in Current Clinical Practice: The Clinical Outcomes Assessment Program of the State of Washington. 18, 206-215.

Hernandez F, Cohn WE, Baribeau YR (2001) In-hospital outcomes of off-pump versus on-pump coronary artery bypass procedures: a multicenter experience. 72, 1528-1533.

Caputo Yeatman M, Narayan P, Ascione Ghosh A.K, Ryder I, Angelini G.D (2002) Intracoronary shunts reduce transient intraoperative myocardial dysfunction during off-pump coronary operations. 73(5), 1411-1417. https://doi.org/10.1016/s0003-4975(02)03407-0

Tugtekin SM, Gulielmos V, Cichon R (2000) Off-pump surgery for anterior vessels in patients with severe dysfunction of the left ventricle. 70, 1034-1036.

Joseph Sabik, Eugene Blackstone, Bruce Lytle, Penny Houghtaling, A. Gillinov, Delos Cosgrove (2004) Equivalent midterm outcomes after off-pump and on-pump coronary surgery J Thorac Cardiovasc Surg. 127(1), 142-148. https://doi.org/10.1016/j.jtcvs.2003.08.046

Zbynek Straka, Petr Widimsky, Karel Jirasek, Petr Stros, Jan Votava, Tomas Vanek, Petr Brucek, Miroslav Kolesar, Rudolf Spacek (2004) Off-pump versus on-pump coronary surgery: final results from a prospective randomized study PRAGUE-4 Ann Thorac Surg. 77(3), 789-793. https://doi.org/10.1016/j.athoracsur.2003.08.039

Vettath (2004) Vettath's Anastamotic Obturator-Our Experience of 269 Proximal Anastomoses. 13, 288-290.

Gerola LR, Buffolo E, Jasbik W (2004) Off-pump versus on-pump myocardial revascularization in low-risk patients with one or two vessel disease: perioperative results in a multicenter randomized controlled trial. 77, 569-573.

Lee JD, Lee SJ, Tsushima WT (2003) Benefits of off-pump bypass on neurologic and clinical morbidity: a prospective randomized trial. 76, 18-25.

P. Lingaas, P. Hol, R. Lundblad (2004) Clinical and angiographic outcome of coronary surgery with and without cardiopulmonary bypass: a prospective randomized trial. 7, 37-41.

Wijeysundera (2005) D N., Beattie W S., Djaiani G., Off- Pump Coronary Artery Surgery for Reducing Mortality and Morbidity, Meta-Analysis of Randomized and Observational Studies. 46, 872-882.

Abreu JE, Reilly J, Salzano RP (1999) Comparison of frequencies of atrial fibrillation after coronary artery bypass grafting with and without the use of cardiopulmonary bypass Am J Cardiol. 83(5), 775-776. https://doi.org/10.1016/s0002-9149(98)00988-6

Van GJ, Nathoe HM, Jansen EW (2004) Meta-analysis on the effect of off-pump coronary bypass surgery1. 26, 81-84.

Parolari A, Alamanni F, Cannata A (2003) Off-pump versus on-pump coronary artery bypass: meta-analysis of currently available randomized trials. 76(1), 37-40. https://doi.org/10.1016/s0003-4975(03)00183-8

Reston JT, Tregear SJ, Turkelson CM (2003) Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting. 76, 1510-1515.

Ascione R, Lloyd CT, Gomes WJ (1999) Beating versus arrested heart revascularization: evaluation of myocardial function in a prospective randomised study. 15, 685-690.

Ascione R, Lloyd CT, Underwood MJ (1999) On-pump versus off-pump coronary revascularization: evaluation of renal function. 68, 493-498.

S. Serum (2000) Serum S-100 protein release and neuropsychologic outcome during coronary revascularization on the beating heart: A prospective randomized study. 119, 148-154.

Ascione R, Lloyd CT, Underwood MJ (1999) Economic outcome of off-pump coronary artery bypass surgery: a prospective randomized study. 68, 2237-2242.