Repositorio
Institucional

Bahamondi, Juan Carlos

Cirugía coronaria sin circulación extracorpórea después de 20 años. Resultado y seguimiento en 1.353 pacientes en el sur de Chile

SOC MEDICA SANTIAGO

REVISTA MEDICA DE CHILE

es

Background: The benefits of off-pump coronary artery bypass graft (OPCAB) compared with conventional on-pump corollary artery bypass graft are not well established although several studies show excellent long-term results. Aim: To assess and report the long-term results of OPCAB surgery in a 20-year period in a Chilean Regional Cardiac Surgery Center. Patients and Methods: Retrospective analysis of the medical records and surgical protocols of 1353 patients aged 61.3 +/- 6.5 years, (69% males) subjected to OPCAB between June 1999 and December 2019. Results: Thirty-four percent of patients presented with unstable angina. On angiography, the left main coronary artery had a proximal obstruction in 15% of patients. Thirty five percent presented with a myocardial infarction of different territories. Thirty percent of patients were managed previously with angioplasty. Preoperative left ventricular function was 45.3% (30-65%). The mean surgical risk Euroscore was 2.84. The mean number of bypasses was 2.7 +/- 0.63. 2.6%. Conversion to on pump technique was required in 2.6% of patients. Operative mortality was 2%, myocardial infarction occurred in 3.4%, a new revascularization procedure was required in 2.3% and 2.4% of patients had a stroke. Long term follow up was complete in most patients and 93% are in NHYA functional capacity I. Actuarial survival was 100, 98, 89, 75 and 66% at 1, 5,10, 15 and 20 years. Actuarial combined cardiovascular events free survival was 100, 98, 87, 68 and 51% at 1,5,10, 15 and 20 years. Conclusions: OPCAB surgery is a safe surgical technique, with an excellent bypass durability and permeability. It also provides a prolonged time free from cardiac events such as mortality, angina, myocardial infarction, and freedom from a new coronary procedure.

artículo original

10.4067/s0034-98872021001001412

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Coronary Artery Bypass

Off-Pump

Cardiac Surgical Procedures

INTERNAL MAMMARY ARTERY

OFF-PUMP

ON-PUMP

FOLLOW-UP

5-YEAR OUTCOMES

GRAFT PATENCY

REVASCULARIZATION

MORTALITY

TRIALS

Medicina general e interna

Bypass de la arteria coronaria

Sin bomba

Procedimientos quirúrgicos cardíacos

ARTERIA MAMARIA INTERNA

CON BOMBA

SEGUIMIENTO

RESULTADOS A 5 AÑOS

PATENCIÓN DEL INJERTO

REVASCULARIZACIÓN

MORTALIDAD

ENSAYOS

Cirugía coronaria sin circulación extracorpórea después de 20 años. Resultado y seguimiento en 1.353 pacientes en el sur de Chile

1412

1422

artículo original

version publicada

CC BY 4.0

CC BY 4.0

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