Published 2017
| Version v1
Publication
Prognostic Impact of Prolonged Cross-Clamp Time in Coronary Artery Bypass Grafting
Creators
- Ruggieri, Vito G.
- Bounader, Karl
- Verhoye, Jean Philippe
- Onorati, Francesco
- Rubino, Antonino S.
- Gatti, Giuseppe
- Tauriainen, Tuomas
- De Feo, Marisa
- Reichart, Daniel
- Dalén, Magnus
- Svenarud, Peter
- Faggian, Giuseppe
- Santarpino, Giuseppe
- Maselli, Daniele
- Gherli, Riccardo
- Mariscalco, Giovanni
- Salsano, Antonio
- Nicolini, Francesco
- Gherli, Tiziano
- Saccocci, Matteo
- Airaksinen, Juhani K. E.
- Chocron, Sidney
- Perrotti, Andrea
- Biancari, Fausto
Contributors
Others:
- Ruggieri, Vito G.
- Bounader, Karl
- Verhoye, Jean Philippe
- Onorati, Francesco
- Rubino, Antonino S.
- Gatti, Giuseppe
- Tauriainen, Tuoma
- De Feo, Marisa
- Reichart, Daniel
- Dalã©n, Magnu
- Svenarud, Peter
- Faggian, Giuseppe
- Santarpino, Giuseppe
- Maselli, Daniele
- Gherli, Riccardo
- Mariscalco, Giovanni
- Salsano, Antonio
- Nicolini, Francesco
- Gherli, Tiziano
- Saccocci, Matteo
- Airaksinen, Juhani K. E.
- Chocron, Sidney
- Perrotti, Andrea
- Biancari, Fausto
Description
Background: The prognostic impact of cross-clamp time (XCT) in patients undergoing isolated coronary artery bypass grafting (CABG) has not been thoroughly investigated. Material and Methods: 2957 patients who underwent on-pump isolated CABG from the prospective multicentre E-CABG study were the subjects of this analysis. Results: The mean XCT in this series was 58. ±. 25. minutes Cross-clamp time was >60 minutes in 1134 patients (38.3%), >75. minutes in 619 patients (20.9%) and >90. minutes in 296 patients (10.0%). Multivariate analysis showed that XCT was an independent predictor of 30-day mortality (p. <. 0.0001, OR 1.027, 95%CI 1.015-1.039) along with age (p. <. 0.0001), female gender (p = 0.001), pulmonary disease (p = 0.001), poor mobility (p = 0.002), urgency status (p = 0.007), critical preoperative status (p = 0.002) and participating centres (p = 0.015). Adjusted risk of 30-day mortality was highest for XCT >75. minutes (2.9% vs. 1.7%, p = 0.002, OR 3.479, 95%CI 1.609-7.520). Analysis of 428 propensity score matched pairs showed that XCT >75. minutes was associated with significantly increased risk of early mortality, prolonged use of inotropes, postoperative use of intra-aortic balloon pump, use of extracorporeal membrane oxygenation, atrial fibrillation, prolonged stay in the intensive care unit and of composite major adverse events. Conclusions: Isolated CABG is currently performed with prolonged XCT in a significant number of patients and this seems to be a determinant of poor early outcome.
Additional details
Identifiers
- URL
- http://hdl.handle.net/11567/935843
- URN
- urn:oai:iris.unige.it:11567/935843
Origin repository
- Origin repository
- UNIGE