Operative risk assessment in coronary artery bypass surgery, 1990-1993: evaluation of perioperative variables.
(1995) The Thoracic and Cardiovascular Surgeon — Vol. 43, n° 3, p. 134-141 (1995)
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- Patient characteristics and the results of cardiac surgery change with time. To achieve the best possible treatment a continual analysis of results is necessary. The present study analyzes 1225 consecutive patients undergoing isolated aortocoronary bypass surgery for the four-year period ending September 1993. Average age was 63 years (range 32-86 years), 927 (75.7%) patients were male and 298 (24.3%) were female. Hospital mortality was 2.2% (17/787) for elective surgery, 6.3% (21/336) for urgent surgery, and 9.8% (8/82) for emergency surgery. Intraoperative variables increasing independently operative mortality as evidenced by multivariate analysis were the following: prolonged aortic cross-clamping time (p < 0.0001), absence of cold-blood cardioplegia (p = 0.0012), absence of bilateral use of internal mammary artery (p = 0.0035). Likewise, intraoperative variables influencing major adverse outcome (operative mortality and/or need for intra-aortic balloon pulsation) were the following: prolonged aortic cross-clamping time (p < 0.0001), absence of cold-blood cardioplegia (p = 0.0360). In conclusion, global ischemic time was the dominant variable in predicting operative outcome. Furthermore, a protective effect of cold blood cardioplegia and bilateral internal mammary artery grafting was evidenced.
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Louagie, Y., Buche, M., Jamart, J., Eucher, P., Haxhe, J.-J., & Schoevaerdts, J.-C. (1995). Operative risk assessment in coronary artery bypass surgery, 1990-1993: evaluation of perioperative variables. The Thoracic and Cardiovascular Surgeon, 43(3), 134-141. https://doi.org/10.1055/s-2007-1013787 (Original work published 1995)