Key result
A time difference between cardiopulmonary bypass and cross-clamping times >30 minutes (with CPB <140 min) was associated with increased in-hospital mortality (OR 2.17; 95% CI 1.30-3.60) after CABG.
Why the study?
The influence of the time difference between cardiopulmonary bypass and aortic cross-clamping times on complications after coronary artery bypass grafting remains poorly understood.
Does a time difference between cardiopulmonary bypass and cross-clamping times > 30 minutes increase the risk of immediate complications in patients undergoing coronary artery bypass grafting?
Cohort (n=3,090)
Yes
Does a time difference between cardiopulmonary bypass and cross-clamping times > 30 minutes increase the risk of immediate complications in patients undergoing coronary artery bypass grafting?
Answers are grounded in this paper and cite their sources.
A time difference of more than 30 minutes between cardiopulmonary bypass and aortic cross-clamping is a significant predictor of immediate postoperative complications and mortality after CABG.
INTRODUCTION: Along with cardiopulmonary bypass time, aortic cross-clamping time is directly related to the risk of complications after heart surgery. The influence of the time difference between cardiopulmonary bypass and cross-clamping times (TDC-C) remains poorly understood. OBJECTIVE: To assess the impact of cardiopulmonary bypass time in relation to cross-clamping time on immediate results after coronary artery bypass grafting in the Registro Paulista de Cirurgia Cardiovascular (REPLICCAR) II. METHODS: Analysis of 3,090 patients included in REPLICCAR II database was performed. The Society of Thoracic Surgeons outcomes were evaluated (mortality, kidney failure, deep wound infection, reoperation, cerebrovascular accident, and prolonged ventilation time). A cutoff point was adopted, from which the increase of this difference would affect each outcome. RESULTS: After a cutoff point determination, all patients were divided into Group 1 (cardiopulmonary bypass time < 140 min., TDC-C < 30 min.), Group 2 (cardiopulmonary bypass time < 140 min., TDC-C > 30 min.), Group 3 (cardiopulmonary bypass time > 140 min., TDC-C < 30 min.), and Group 4 (cardiopulmonary bypass time > 140 min., TDC-C > 30 min.). After univariate logistic regression, Group 2 showed significant association with reoperation (odds ratio: 1.64, 95% confidence interval: 1.01-2.66), stroke (odds ratio: 3.85, 95% confidence interval: 1.99-7.63), kidney failure (odds ratio: 1.90, 95% confidence interval: 1.32-2.74), and in-hospital mortality (odds ratio: 2.17, 95% confidence interval: 1.30-3.60). CONCLUSION: TDC-C serves as a predictive factor for complications following coronary artery bypass grafting. We strongly recommend that future studies incorporate this metric to improve the prediction of complications.
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Jucá et al. (2024) conducted a cohort in Coronary artery bypass grafting (n=3,090). Time difference between cardiopulmonary bypass and cross-clamping times (TDC-C) > 30 min with CPB time < 140 min vs. TDC-C < 30 min was evaluated on In-hospital mortality (OR 2.17, 95% CI 1.30-3.60). A time difference between cardiopulmonary bypass and cross-clamping times >30 minutes (with CPB <140 min) was associated with increased in-hospital mortality (OR 2.17; 95% CI 1.30-3.60) after CABG.
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