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"WU Ruobin" 2 results
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Objective To learn the predictive risk factors of acute conversion of off-pump coronary artery bypass grafting (off-pump CABG)to on-pump coronary artery bypass grafting (on-pump CABG), referring for making decision in operating. Methods During Jan. 2002 to May 2006, 546 patients underwent planned off-pump CABG were analyzed retrospectively, and cases of acute conversion of off-pump to on-pump CABG (converted group) were compared with unconverted to on-pump(off-pump group) by multivariate logistic regression. Results 24 patients of off-pump CABG were acutely converted to on-pump CABG because of ventricular fibrillation or unstable hemodynamics. The mortality in converted group was 16.7%(4/24), much higher than off-pump group ［27% (14/522) , P＜0.001］. By multivariable logistic regression, acute myocardial infarction (OR=3.142,P=0004), emergent CABG (OR=1.571,P=0.011) and right main coronary artery(RCA) stenosis less than 90% (OR=1922,P=0.024) were predictors of acute conversion of off-pump to on-pump. Conclusions The mortality in patients undergoing acute conversion of off-pump to on-pump coronary artery surgery is high. When applying off-pump CABG in patients with acute myocardial infarction, emergency CABG and right main RCA stenosis ≤90%, preventive set up of extracorporeal circulation is necessary.
Release date：2016-08-30 06:16
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Objective To study the relation between competitive flow and graft flow in coronary artery bypass grafting. Methods Twelve adult healthy dogs （weighing 27. 62 ± 1. 63 kg） were anesthetized and received offpump coronary artery bypass grafting. During operation, flow meter was used to measure the degree of stenosis, and according to which four groups were classified. They were： non-stenosis group, 33% stenosis group, 50% stenosis group and 75 % stenosis group. Hemodynamic parameters including flow volume of graft, pulsatility indes （PI）, heart rate（HR） and mean arterial pressure（MAP） were recorded with or without competitive flow. Results When there was a competitive flow, the flow volume of graft in all four groups was less than the flow volume of graft which has not been affected by competitive flow. PI of non-stenosis group and 33% stenosis group was lower than normal PI. 50% stenosis group PI decreased from 8. 36±3. 52 to 3. 02±0. 94; 75% stenosis group PI was more than 5. Conclusion Competitive flow will restrain the graft flow. The position of graft anastomosis may be affected graft＇s patency.
Release date：2016-08-30 06:26
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