Key result
Off-pump to on-pump CABG conversion carries an ~18% rate of severe ischemic complications.
Why the study?
Outcomes and management strategies for patients undergoing CABG without CPB who require conversion to CPB due to technical or hemodynamic issues were not well characterized.
What are the clinical outcomes and complication rates associated with converting from off-pump to on-pump CABG?
Population
1000 patients undergoing CABG at University Clinical Centre Tuzla
Comparison
Converted OPCAB to ONCAB vs planned ONCAB and successful OPCAB
Design
Observational cohort study
Authors
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Emergent conversion carries high ischemic morbidity; leaves open optimal selection to minimize unplanned shifts in off-pump CABG.
Observational (n=1,000)
No
What are the clinical outcomes and complication rates associated with converting from off-pump to on-pump CABG?
Absolute Event Rate: 17.9% vs 1.3%
Emergent conversion from off-pump to on-pump CABG due to cardiac arrest or severe hemodynamic instability is associated with significant morbidity, highlighting the need to minimize such conversions.
Mujanović et al. (2008) conducted an observational in Coronary artery disease requiring multivessel CABG (n=1,000). Conversion to cardiopulmonary bypass (CPB) vs. Planned off-pump CABG without conversion was evaluated on Ischemic complications (stroke and requirement for intraaortic balloon pump). Conversion from off-pump to on-pump coronary artery bypass grafting occurred in 7.7% of planned off-pump cases, with emergent conversions due to cardiac arrest resulting in a 66.6% rate of severe ischemic complications.
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