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Eur J Cardiothorac Surg 2007;32:488-492. doi:10.1016/j.ejcts.2007.05.025
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Predictors of prolonged mechanical ventilation following aorta no-touch off-pump coronary artery bypass surgery

Sotirios N. Prapasa, Ioannis A. Panagiotopoulosa, Ashraf Hamed Abdelsalama,*, Vasilios N. Kotsisa, Dimitrios A. Protogerosa, Ioannis N. Linardakisa, Fotini N. Danoub

a Department of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece
b Department of Anesthesia, Henry Dunant Hospital, Athens, Greece

Received 3 March 2007; received in revised form 22 May 2007; accepted 24 May 2007.

* Corresponding author. Current address: Department of Cardiothoracic Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt. Tel.: +20105197377. (Email: ashrafhamid73{at}yahoo.com).

Objective: To identify parameters associated with prolonged mechanical ventilation (PMV) (>48 h) after off-pump coronary artery bypass (OPCAB) in our patient population. Materials and methods: From February 2001 to November 2005, we operated on 1359 patients for isolated coronary revascularization with the {pi}-circuit technique, consisting of: (1) beating heart, (2) OPCAB, (3) aorta no-touch, (4) use of composite grafts, and (5) arterial revascularization. Results: From the total number of our patients, 1320 patients had been extubated within 48 h postoperatively (Group A) and 39 patients needed PMV (Group B). In our study we have found that PMV were associated with advanced age (64.74 ± 9.85 Group A vs 68.43 ± 10.03 Group B, p < 0.02) as well as higher incidence with octogenarians (4.4% Group A vs 10.2% Group B, p = 0.09). Patients with preoperative history of transient ischemic attacks (TIAs) or stroke were more likely to belong to Group B (1.5% Group A vs 7.7% Group B, p < 0.02; 2.8% Group A vs 10.3% Group B, p < 0.02, respectively). Preoperative intra-aortic balloon pump (IABP) insertion was associated with PMV (1.6% Group A vs 15.4% Group B, p < 0.0005). Unexpectedly, neither COPD nor obesity was associated with PMV (4.9% Group A vs 7.7% Group B, p = NS, 21.7% Group A vs 23.1% Group B, p = NS, respectively). Conclusion: In this study, PMV following aorta no-touch OPCAB was related to preoperative variables: age, octogenarians, preoperative IABP, TIA, and stroke. There was no relation between PMV and any of the operative data.

Key Words: OPCAB • Aorta no-touch • Mechanical ventilation






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.