ArticleCureus2023
Predicting Determinants for Conversion of Off-Pump Coronary Revascularization to On-Pump Surgery: A Retrospective Analysis.
Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A global consensus has not yet been reached regarding the preference for off-pump versus on-pump coronary revascularization. Although the coronary trial indicates that the secondary endpoint outcomes favor on-pump surgery, the cost-effectiveness and significantly lower immediate and early complications in off-pump surgery make it favorable for the Indian population. To analyze patients who underwent coronary revascularization, specifically coronary artery bypass grafting (CABG), a retrospective five-year study was conducted. During the given duration, a total of 652 patients underwent CABG. The study revealed a positive correlation between diabetes, high body surface area (BSA), and preexisting renal dysfunction as strong predictors for converting off-pump coronary artery bypass surgery (OPCABG) to on-pump surgery coronary artery bypass surgery (ONCABG). Preoperative electrocardiographic (ECG) changes and the use of intra-aortic balloon pulsation (IABP) as a mechanical assist device were strongly associated with the incidence of conversion from OPCABG to ONCABG. Tight left main disease and ostial coronary disease indicate a progressive dysfunction during off-pump surgery, necessitating early conversion to on-pump surgery to avoid complications. The on-pump group had more adverse outcomes in regard to renal and neurological dysfunction, which can be attributed to pump-induced dysfunction. In such scenarios, a surgeon's preparedness to convert an OPCABG to an ONCABG can be swift and efficient. In anticipation of increased pump-related complications in the ONCABG group, a measured approach can be implemented to avoid adverse postoperative outcomes in high-risk patients.
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