Minimally invasive extracorporeal circulation: excellent outcome and life expectancy after coronary artery bypass grafting surgery

• Published in: Swiss medical weekly 2017-07, Vol.147 (2728), p.w14474-w14474
• Main Authors: Winkler, Bernhard, Heinisch, Paul Philipp, Zuk, Grzegorz, Zuk, Katarzyna, Gahl, Brigitta, Jenni, Hans-Jörg, Kadner, Alexander, Huber, Christoph, Carrel, Thierry
• Format: Article
• Language: English
• Subjects: Aged; artery; bypass; circulation; Cohort Studies; coronary; Coronary Artery Bypass - methods; Coronary Artery Bypass - mortality; coronary artery bypass grafting; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; expectancy; Extracorporeal Circulation - methods; Extracorporeal Circulation - mortality; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Life Expectancy; Male; Middle Aged; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Period; Treatment Outcome
• ISSN: 1424-7860; 1424-3997
• DOI: 10.4414/smw.2017.14474

Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre. We evaluated morbidity and mortality follow-up data with a median follow-up of 3.6 years. Kaplan-Meier curves and estimates of the primary end-point for all-cause mortality were compared with the life expectancy of the general population. Mortality in CABG patients was comparable to the general population beginning 1 year after surgery for the whole observation period. All-cause 30-day mortality was 0.8%. The mean estimated logistic EuroSCORE and EuroSCORE II were 5.8 ± 8.6 and 3.0 ± 5.1, respectively. Mean perfusion time was 71.1 ± 23.8 min with a cross-clamp time of 44.9 ± 16.3 min. Mortality was predicted by the presence of diabetes mellitus (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.40-2.46; p