Transverse Heart; A New Conversıon Predictor From offpump to on-Pump Surgery Volume 3 - Issue 4

Mehmet Ali Şahin, Mehmet Yokusoglu, Ertuğrul Özal and Erkan Kuralay*

• Alife Hospital Cardiac Surgery Department Ankara-Turkey

Received:May 3, 2021;   Published: May 13, 2021

Corresponding author: Erkan Kuralay, Alife Hospital Cardiac Surgery Department Ankara-Turkey

DOI: 10.32474/ACR.2021.03.000168

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Abstract

Introduction: Risk of conversion to on-pump surgery is one of the concerns about off-pump CABG surgery. Conversion to onpump surgery carries high morbidity and mortality risk. Our study aimed to investigate the relation between transverse heart and the risk of conversion to on-pump CABG .

Materials and Methods: Our study consisted of 3000 patients who underwent isolated off-pump CABG surgery between June 2010 and February 2020. All patients have at least one CABG in the Cx region. We have described vertical and transverse heart according to angle between the left anterior descending artery (LAD) and the left part of the sternal retractor.

Results: Our conversion rate was 7.1%. The average intensive care unit (ICU) stay was 1.17±0.10 days in successful off-pump surgery but 3.11±2.11 days in converted surgery (p=0.001).Average hospital stay was 4.35±1.44 days in off-pump surgery but 7.28±3.31 days (p=0.001) in converted surgery. Twenty-eight patients (1%) died in successful off-pump surgery, but 12 patients (5.6%) died in off-to-on converted surgery(p=0.001).Multivariate analysis has shown that ejection fraction less than 30% (LVEF<30%), cardiomegaly, congestive heart failure (CHF), and transverse heart as a predictor of conversion.

Conclusion: Conversion to off-to-on surgery still has contraversial results. Analysis of predictors preoperative and inspection of heart just before coronary anastomosis should be carefully done. The transverse heart was the statistically significant off-to-on conversion predictor of our study.

Keywords: Off-Pump Surgery; Vertical Heart; Transverse Heart

Abstract| Introduction| Material and Methods| Surgical Technique| Results| Comments| Conclusion| References|