Perioperative Advantages of Off-Pump Coronary Artery Bypass Grafting
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概要
- 論文の詳細を見る
For the first time in Japan, off-pump coronary artery bypass grafting (OPCAB) was compared with the conventional on-pump technique, retrospectively examining the morbidity associated with coronary artery bypass grafting (CABG) and assessing the efficacy of OPCAB. In 2000, 158 patients underwent CABG: 95 patients (60%) had OPCAB (Group I) and 63 patients (40%) had conventional CABG (Group II). The operating time, length of intensive care unit (ICU) stay, ventilation time, postoperative bleeding, transfusion, postoperative renal function, occurrence of stroke, and early graft patency were examined in both groups. There were no hospital deaths in either group. The operating time, ICU stay, and ventilation time were significantly (p<0.0001, p=0.013, and p<0.0001, respectively) shorter in Group 1(351★85 min, 3.0★1.4 days and 5.1★2.8h) than in Group II (449★112 min, 3.6★1.8days and 13 7★18.0h). The postoperative blood loss within 12h and the transfusion volume were significantly (p=0.0004 and p<0.0001, respectively) smaller in Group I (480★210 ml and 300★490 ml) than in Group II (720★430ml and 1,230★1,180ml). Peak serum blood urea nitrogen and creatinine concentrations (excluding patients with preoperative chronic renal failure, ie a preoperative serum creatinine >1.5 mg/dl) were significantly (p<0.0001 and p<0.0001, respectively) lower in Group I (16.2★15.2mg/dl and 0.81★0.72mg/dl) than in Group II (19.2★7.6mg/dl and 0.92★0.28mg/dl). There were no perioperative strokes in Group I, but 6.4% of Group II patients suffered a stroke. There was no significant difference in graft patency between the groups (95.6% vs 94.9%). OPCAB reduced the mortality and morbidity of coronary revascularization, with a shorter operating time and more rapid recovery from surgery.
- 社団法人日本循環器学会の論文
- 2002-08-20
著者
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KITAMURA Soichiro
Department of Cardiovascular Surgery, National Cardiovascular Center
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Kobayashi Junjiro
Department of Cardiac Surgery, National Cardiovascular Center
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Nakajima Hiroyuki
Department of Cardiology, National Cardiovascular Center
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Niwaya Kazuo
Department of Organ Transplantation
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Tagusari Osamu
Department of Cardiovascular Surgery
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Nakajima Hiroyuki
Department Of Organ Transplantation Cardiovascular Surgery National Cardiovascular Center
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Niwaya Kazuo
Department Of Cardiovascular Surgery National Cardiovascular Center
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Tagusari Osamu
Department Of Cardiovascular Surgery Kanto Medical Center Ntt East Corporation
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Ishida Michiko
Departments of Regenerative Medicine and Tissue Engineering
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Band Ko
Cardiovascular Surgery National Cardiovascular Center
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Bandoh Ko
Department Of Cardiovascular Surgery National Cardiovascular Center
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Bando Ko
Departments of Cardiovascular Surgery, National Cardiovascular Center
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Tsukamoto Osamu
Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine
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Kobayashi Junjiro
Department Of Applied Physics School Of Science And Engineering Waseda University
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Kitamura Soichiro
Department Of Cardiology National Cardiovascular Center
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Ishida Michiko
Department Of Cardiovascular Surgery National Cardiovascular Center
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Ishida Michiko
Department Of Cardiovascular Surgery Fujita Health University
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Bando Ko
Department Of Cardiovascular Surgery
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Tagusari Osamu
Department Of Cardiovascular Surgery The Heat Institute Of Japan Tokyo Women's Medical Universi
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Nishigami Kazuhiro
National Cardiovascular Center Research Institute
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Nakajima Hiroyuki
Department Of Cardiology National Cerebral And Cardiovascular Center
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