Clinical Characteristics and Risk Factors in Patients Undergoing Conversion from Off-pump Coronary Artery Bypass Grafting to On-pump Coronary Artery Bypass Grafting
Objective To observe the clinical characteristics and risk factors of patients undergoing off-pump coronary artery bypass grafting(OPCABG)or on-pump coronary artery bypass grafting(ONCABG).Methods The clinical data of 90 patients with coronary heart disease(CHD)who underwent OPCABG and were urgently converted to ONCABG intraoperatively were retrospectively analyzed and categorized into the transit group.Another 300 CHD patients who underwent OPCABG alone in the same period were selected as the non-cardiopulmonary bypass group.The preoperative and intraoperative clinical characteristics of the patients in the two group were observed,and multivariate logistic regression analysis was used to influence the risk factors of emergency transit cardiopulmonary bypass in OPCABG patients.Results There was no statistically significant difference between the 2 groups in terms of gender,age,body mass index(BMI),history of diabetes mellitus,history of hypertension,history of hyperlipidemia,history of chronic obstructive pulmonary disease,history of stroke,history of peripheral vascular disease,left main stem lesion,anterior descending branch lesion,echogenic branch lesion,atrial fibrillation,rate of use of the left internal mammary artery,and rate of use of the radial artery(P＞0.05).The history of heart failure,history of percutaneous coronary intervention(PCI),right coronary lesion,percentage of myocardial infarction within 3 weeks and number of bridging vessels in the transit group were higher than those in the non-cardiopulmonary bypass group,and the left ventricular ejection fraction(LVEF)data were lower than those in the non-cardiopulmonary bypass group,and the difference was statistically significant(P＜0.05).As confirmed by multifactorial logistic regression analysis,history of preoperative heart failure,history of preoperative PCI,a preoperative right coronary lesion,and a history of myocardial infarction within 3 weeks of surgery were all risk factors for the occurrence of an emergency transfer cardiopulmonary bypass in patients with OPCABG(P＜0.05).Conclusion The history of preoperative heart failure,preoperative PCI,preoperative right coronary lesion,and history of myocardial infarction within 3 weeks of surgery are all risk factors for the occurrence of emergency transfer to cardiopulmonary bypass in patients with OPCABG,and clinics can reduce the risk of a patient being transferred by controlling the above risk factors.
万方数据
维普
