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

• Published in: European journal of cardio-thoracic surgery Vol. 32; no. 3; pp. 488 - 492
• Main Authors: Prapas, Sotirios N., Panagiotopoulos, Ioannis A., Hamed Abdelsalam, Ashraf, Kotsis, Vasilios N., Protogeros, Dimitrios A., Linardakis, Ioannis N., Danou, Fotini N.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01-09-2007; Elsevier Science
• Subjects: Aged; Aged, 80 and over; Aorta - surgery; Aorta no-touch; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Bypass, Off-Pump - methods; Coronary heart disease; Female; Heart; Humans; Male; Mechanical ventilation; Medical sciences; Middle Aged; OPCAB; Postoperative Complications - prevention & control; Prospective Studies; Respiration, Artificial; Risk Assessment; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Ventricular Function - physiology; OPCAB; Mechanical ventilation; Aorta no-touch; Predictor; Prediction; Cardiovascular disease; Artificial ventilation; Coronary heart disease; Pump; Tactile sensitivity; Coronary artery bypass; Aorta; Predictive factor; Prolonged
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2007.05.025

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 π-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.