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Minimally invasive extracorporeal circulation: excellent outcome and life expectancy after coronary artery bypass grafting surgery
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 circulatio...
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| Published in: | Swiss medical weekly 2017-07, Vol.147 (2728), p.w14474-w14474 |
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| container_issue | 2728 |
| container_start_page | w14474 |
| container_title | Swiss medical weekly |
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| creator | Winkler, Bernhard Heinisch, Paul Philipp Zuk, Grzegorz Zuk, Katarzyna Gahl, Brigitta Jenni, Hans-Jörg Kadner, Alexander Huber, Christoph Carrel, Thierry |
| description | 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 |
| doi_str_mv | 10.4414/smw.2017.14474 |
| format | article |
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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 <0.001), peripheral arterial disease (OR 2.36, 95% CI 1.64-3.38; p <0.001), severe obstructive pulmonary disease (OR 3.21, 1.42-7.24; p = 0.005), chronic renal failure (OR 3.68, 2.49-5.43; p <0.001) and transfusion of more than one unit of erythrocyte concentrate in the perioperative period (OR 1.46, 1.09-1.95; p = 0.015). Cerebrovascular events occurred in 36 patients (1.7%).
CABG with use of MiECC is associated with a mortality rate comparable to the overall life expectancy of the general population. MiECC is the first choice for routine and emergency CABG at our centre with a 30-day mortality rate of 0.8% and a low complication rate.</description><identifier>ISSN: 1424-7860</identifier><identifier>EISSN: 1424-3997</identifier><identifier>DOI: 10.4414/smw.2017.14474</identifier><identifier>PMID: 28695560</identifier><language>eng</language><publisher>Switzerland: SMW supporting association (Trägerverein Swiss Medical Weekly SMW)</publisher><subject>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</subject><ispartof>Swiss medical weekly, 2017-07, Vol.147 (2728), p.w14474-w14474</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c401t-6ddfe8fba7291d94e8c69b6308f9562429be16c1125aadefbac615633df802823</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28695560$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Winkler, Bernhard</creatorcontrib><creatorcontrib>Heinisch, Paul Philipp</creatorcontrib><creatorcontrib>Zuk, Grzegorz</creatorcontrib><creatorcontrib>Zuk, Katarzyna</creatorcontrib><creatorcontrib>Gahl, Brigitta</creatorcontrib><creatorcontrib>Jenni, Hans-Jörg</creatorcontrib><creatorcontrib>Kadner, Alexander</creatorcontrib><creatorcontrib>Huber, Christoph</creatorcontrib><creatorcontrib>Carrel, Thierry</creatorcontrib><title>Minimally invasive extracorporeal circulation: excellent outcome and life expectancy after coronary artery bypass grafting surgery</title><title>Swiss medical weekly</title><addtitle>Swiss Med Wkly</addtitle><description>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 <0.001), peripheral arterial disease (OR 2.36, 95% CI 1.64-3.38; p <0.001), severe obstructive pulmonary disease (OR 3.21, 1.42-7.24; p = 0.005), chronic renal failure (OR 3.68, 2.49-5.43; p <0.001) and transfusion of more than one unit of erythrocyte concentrate in the perioperative period (OR 1.46, 1.09-1.95; p = 0.015). Cerebrovascular events occurred in 36 patients (1.7%).
CABG with use of MiECC is associated with a mortality rate comparable to the overall life expectancy of the general population. MiECC is the first choice for routine and emergency CABG at our centre with a 30-day mortality rate of 0.8% and a low complication rate.</description><subject>Aged</subject><subject>artery</subject><subject>bypass</subject><subject>circulation</subject><subject>Cohort Studies</subject><subject>coronary</subject><subject>Coronary Artery Bypass - methods</subject><subject>Coronary Artery Bypass - mortality</subject><subject>coronary artery bypass grafting</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - surgery</subject><subject>expectancy</subject><subject>Extracorporeal Circulation - methods</subject><subject>Extracorporeal Circulation - mortality</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Life Expectancy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Period</subject><subject>Treatment Outcome</subject><issn>1424-7860</issn><issn>1424-3997</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNo9UcFu1DAQjRCIlsKVI_KRyy624zgxN1QVqFTEBc7WxB6vXDl2sJNCrnw53u7S03hm3rzxm9c0bxndC8HEhzL93nPK-j0TohfPmksmuNi1SvXPz-9-kPSieVXKPaV8kKx72VzUqLpO0svm7zcf_QQhbMTHByj-AQn-WTKYlOeUEQIxPps1wOJT_Fh7BkPAuJC0LiZNSCBaErw7js1oFohmI-AWzKRSpAi5prmmGxm3GUohh1zbPh5IWfOh1l83LxyEgm_O8ar5-fnmx_XX3d33L7fXn-52RlC27KS1Dgc3Qs8Vs0rgYKQaZUsHpzrJBVcjMmkY4x2AxQo0VaxsW-uGKpy3V83tidcmuNdzrrLzphN4_VhI-aDrR70JqEfWCUXriRCVGCUDIXs3uE5Cb5XhY-V6f-Kac_q1Yln05MvxMhAxrUUzxXolW65Ehe5PUJNTKRnd02pG9dFDXT3URw_1o4d14N2Zex0ntE_w_6a1_wDPTptv</recordid><startdate>20170710</startdate><enddate>20170710</enddate><creator>Winkler, Bernhard</creator><creator>Heinisch, Paul Philipp</creator><creator>Zuk, Grzegorz</creator><creator>Zuk, Katarzyna</creator><creator>Gahl, Brigitta</creator><creator>Jenni, Hans-Jörg</creator><creator>Kadner, Alexander</creator><creator>Huber, Christoph</creator><creator>Carrel, Thierry</creator><general>SMW supporting association (Trägerverein Swiss Medical Weekly SMW)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>DOA</scope></search><sort><creationdate>20170710</creationdate><title>Minimally invasive extracorporeal circulation: excellent outcome and life expectancy after coronary artery bypass grafting surgery</title><author>Winkler, Bernhard ; Heinisch, Paul Philipp ; Zuk, Grzegorz ; Zuk, Katarzyna ; Gahl, Brigitta ; Jenni, Hans-Jörg ; Kadner, Alexander ; Huber, Christoph ; Carrel, Thierry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c401t-6ddfe8fba7291d94e8c69b6308f9562429be16c1125aadefbac615633df802823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>artery</topic><topic>bypass</topic><topic>circulation</topic><topic>Cohort Studies</topic><topic>coronary</topic><topic>Coronary Artery Bypass - methods</topic><topic>Coronary Artery Bypass - mortality</topic><topic>coronary artery bypass grafting</topic><topic>Coronary Artery Disease - mortality</topic><topic>Coronary Artery Disease - surgery</topic><topic>expectancy</topic><topic>Extracorporeal Circulation - methods</topic><topic>Extracorporeal Circulation - mortality</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Life Expectancy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Period</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Winkler, Bernhard</creatorcontrib><creatorcontrib>Heinisch, Paul Philipp</creatorcontrib><creatorcontrib>Zuk, Grzegorz</creatorcontrib><creatorcontrib>Zuk, Katarzyna</creatorcontrib><creatorcontrib>Gahl, Brigitta</creatorcontrib><creatorcontrib>Jenni, Hans-Jörg</creatorcontrib><creatorcontrib>Kadner, Alexander</creatorcontrib><creatorcontrib>Huber, Christoph</creatorcontrib><creatorcontrib>Carrel, Thierry</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Directory of Open Access Journals</collection><jtitle>Swiss medical weekly</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Winkler, Bernhard</au><au>Heinisch, Paul Philipp</au><au>Zuk, Grzegorz</au><au>Zuk, Katarzyna</au><au>Gahl, Brigitta</au><au>Jenni, Hans-Jörg</au><au>Kadner, Alexander</au><au>Huber, Christoph</au><au>Carrel, Thierry</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minimally invasive extracorporeal circulation: excellent outcome and life expectancy after coronary artery bypass grafting surgery</atitle><jtitle>Swiss medical weekly</jtitle><addtitle>Swiss Med Wkly</addtitle><date>2017-07-10</date><risdate>2017</risdate><volume>147</volume><issue>2728</issue><spage>w14474</spage><epage>w14474</epage><pages>w14474-w14474</pages><issn>1424-7860</issn><eissn>1424-3997</eissn><abstract>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 <0.001), peripheral arterial disease (OR 2.36, 95% CI 1.64-3.38; p <0.001), severe obstructive pulmonary disease (OR 3.21, 1.42-7.24; p = 0.005), chronic renal failure (OR 3.68, 2.49-5.43; p <0.001) and transfusion of more than one unit of erythrocyte concentrate in the perioperative period (OR 1.46, 1.09-1.95; p = 0.015). Cerebrovascular events occurred in 36 patients (1.7%).
CABG with use of MiECC is associated with a mortality rate comparable to the overall life expectancy of the general population. MiECC is the first choice for routine and emergency CABG at our centre with a 30-day mortality rate of 0.8% and a low complication rate.</abstract><cop>Switzerland</cop><pub>SMW supporting association (Trägerverein Swiss Medical Weekly SMW)</pub><pmid>28695560</pmid><doi>10.4414/smw.2017.14474</doi><oa>free_for_read</oa></addata></record> |
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| source | Alma/SFX Local Collection |
| 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 |
| title | Minimally invasive extracorporeal circulation: excellent outcome and life expectancy after coronary artery bypass grafting surgery |
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