Revista Cubana de Cirugía
version ISSN 0034-7493
ECHEMENDIA SIMON, Eider Daniel et al. Comparison of results of myocardial revascularization with beating heart, with and without extracorporeal circulation. Rev Cubana Cir [online]. 2011, vol.50, n.1, pp. 25-39. ISSN 0034-7493.
INTRODUCTION. The surgical myocardial revascularization with beating heart and without extracorporeal circulation (ECC) is a potential strategy to decrease the mortality and the morbidity in patients presenting with ischemic heart disease. The objective of present research was to describe the results of surgical myocardial revascularization with beating heart, with or without ECC. METHODS. A prospective, longitudinal and descriptive study was conducted of cases series type where the sample included 159 patients underwent beating heart myocardial revascularization (143 without ECC and 16 with EEC) en the "Hermanos Ameijeiras" Clinical Surgical Hospital in 2007. RESULTS. The mean age of the 159 patients operated on was of 63,9 years. There was predominance of male sex (74,2%), white race (81,1%), chronic and stable exertion angina (86,8%), dyslipidemia (84,3%), high blood pressure (81,2%), use of two or more anti-ischemia drugs (83,0%), III functional class (64,2%), sinus cardiac rhythm (98,1%), trunk lesion associated to multi-vessel disease (54,1%) and sternotomy approach (93,1%). There were statistically significant differences in favor of the patients without ECC as regards the complete revascularization (p = 0,006), inotropic drugs (p = 0,000), haemoderivatives (p = 0,022), surgical time (p = 0,000) and anesthetics (p = 0,000), use of contrapulsation balloon (p = 0,001), medium extubation (p = 0,003) and intensive care unit stay (p = 0,011). The overall mortality was of 5,0%, more significant when ECC was used (p = 0,001) and similar when both techniques were compared in relation to respiratory sepsis, renal dysfunction, pleural effusion, low cardiac output, postoperative hemorrhage and decompensation of diabetes mellitus. CONCLUSIONS. We conclude that the use of extracorporeal circulation as help in beating heart myocardial revascularization yielded unsatisfactory results.
Keywords : Myocardial revascularization; beating heart surgery; coronary surgery assisted with extracorporeal circulation.