الفهرس | Only 14 pages are availabe for public view |
Abstract - In This study 80 high risk patients ”according to EuroSCORE” had CABG, 40 high risk patients had CABG by On pump method, and 40 high risk patients had CABG by OFF pump method . - All the patients were in the same hospital (Police Authority Hospital) , and all the operations were done by the same surgical teams in the period from 2008 to 2011 . - There was no statistical difference between the two groups preoperatively regarding their age , sex , co morbidities , and left ventricular function . - Regarding intra operative comparison , there was a significant difference in the total operation time , as in group B it was significantly less , while the total number of grafts , were significantly higher in group A . - There was a significant difference in the total hospital stay parameters . - The blood loss and blood transfusion require were less in group B , left ventricular function were markedly increased in both group , at follow up , but the difference was not significant between the two groups . - The post operative complication of both groups showed significant percentage of post operative myocardial infarction among OFF pump group , otherwise there was no difference between both groups . To confirm the benefit of each technique , long tem follow up is recommended , but it is believed that every coronary surgeon should have enough experience in On pump , and especially in OFF pump revascularization , so that the bypass operation can be optimally tailored to any individual patients . Because of the high risk patient with multi vessels coronary artery disease , is a very critical patient , with heart liable to ischemia during distal anastomosis , and highly diseased vessels that need good and carefull anastomosis , especially posterior and lateral wall , we recommend to do the coronary revascularization using On Pump technique in high risk patients to avoid the massive heamodynamic changes during distal anastomosis . |