Beating heart coronary artery surgery: is sternotomy a suitable alternative to minimal invasive technique?

Détails

ID Serval
serval:BIB_84E4F42ED19A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Beating heart coronary artery surgery: is sternotomy a suitable alternative to minimal invasive technique?
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
Gersbach  P., Imsand  C., von Segesser  L. K., Delabays  A., Vogt  P., Stumpe  F.
ISSN
1010-7940 (Print)
Statut éditorial
Publié
Date de publication
10/2001
Volume
20
Numéro
4
Pages
760-4
Notes
Comparative Study
Journal Article --- Old month value: Oct
Résumé
OBJECTIVES: To evidence the respective advantages and drawbacks of minimal invasive-thoracotomy (MIDCAB) and off-pump sternotomy (OPCAB) coronary bypass techniques. METHODS: The perioperative and mid-term (3 months) results of the first 31 MIDCABs and 39 OPCABs performed by a single experienced coronary surgeon (F.S.) were compared. Differences were assessed by two-tailed chi-square or unpaired t-test, and significance assumed for P-values < or =0.05. RESULTS: Groups were widely comparable. There were no in-hospital deaths nor permanent neurologic events. OPCAB patients received more anastomoses (mean 1.09/patient vs. 1.89/patient, P<0.001) during a shorter coronary occlusion period (26.1+/-8 vs. 16.6+/-4.5min, P<0.001), whilst immediate extubation prevailed in MIDCABs (22/31 vs. 17/39, P<0.05). Significant complications occurred in seven MIDCABs vs. none in OPCABs (P<0.01). Other in-hospital parameters were similar. Controls at 3 months evidenced more residual discomfort among MIDCAB patients (14/30 vs. 7/39, P<0.05). CONCLUSIONS: Differences in early complication rates may be due to a learning effect. However, OPCAB allows us to implant more grafts and is more comfortable for both patient and surgeon. These advantages may well counterbalance the cosmetic benefits of MIDCAB procedures.
Mots-clé
Aged *Cardiopulmonary Bypass *Coronary Artery Bypass Female Humans Length of Stay Male Middle Aged Outcome and Process Assessment (Health Care) Postoperative Complications/etiology Sternum/*surgery *Surgical Procedures, Minimally Invasive *Thoracotomy
Pubmed
Web of science
Création de la notice
28/01/2008 10:48
Dernière modification de la notice
03/03/2018 18:55
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