A randomized comparison of right ventricular function after on-pump versus off-pump coronary artery bypass graft surgery
Objectives Right ventricular dysfunction occurs very soon after conventional coronary bypass surgery with cardiopulmonary bypass and might not recover within 1 year after the operation. It has been postulated that performing coronary surgery without cardiopulmonary bypass might preserve right ventri...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2011-02, Vol.141 (2), p.361-367 |
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| container_title | The Journal of thoracic and cardiovascular surgery |
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| creator | Michaux, Isabelle, MD, PhD Filipovic, Miodrag, MD Skarvan, Karl, MD Bolliger, Daniel, MD Schumann, Regina, MD Bernet, Franziska, MD Seeberger, Manfred D., MD |
| description | Objectives Right ventricular dysfunction occurs very soon after conventional coronary bypass surgery with cardiopulmonary bypass and might not recover within 1 year after the operation. It has been postulated that performing coronary surgery without cardiopulmonary bypass might preserve right ventricular function. We hypothesized that right ventricular global and overall systolic functions are better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery. Methods Fifty patients scheduled for elective coronary bypass surgery were randomly assigned to conventional or off-pump surgery. Right ventricular function was assessed by means of transthoracic echocardiographic analysis the day before the operation and 3 months later. Right ventricular myocardial performance index was used as a marker of global right ventricular function, and right ventricular fractional area change was used as a marker of overall right ventricular systolic function. Peak systolic velocities of the lateral tricuspid annulus were studied to assess regional systolic function of the right ventricular free wall. Results Surgical intervention was completed according to randomization in 48 of 50 patients. Demographic and perioperative characteristics were similar in the 2 groups. Over the study period, right ventricular myocardial performance index and right ventricular fractional area change did not change in comparison with the baseline values in both groups. Peak systolic velocity of the lateral tricuspid annulus was decreased significantly in both groups 3 months after the operation. There were no significant intergroup differences in any echocardiographic marker of right ventricular function. Conclusions Global right ventricular function was not better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery. |
| doi_str_mv | 10.1016/j.jtcvs.2010.02.023 |
| format | Article |
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It has been postulated that performing coronary surgery without cardiopulmonary bypass might preserve right ventricular function. We hypothesized that right ventricular global and overall systolic functions are better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery. Methods Fifty patients scheduled for elective coronary bypass surgery were randomly assigned to conventional or off-pump surgery. Right ventricular function was assessed by means of transthoracic echocardiographic analysis the day before the operation and 3 months later. Right ventricular myocardial performance index was used as a marker of global right ventricular function, and right ventricular fractional area change was used as a marker of overall right ventricular systolic function. Peak systolic velocities of the lateral tricuspid annulus were studied to assess regional systolic function of the right ventricular free wall. Results Surgical intervention was completed according to randomization in 48 of 50 patients. Demographic and perioperative characteristics were similar in the 2 groups. Over the study period, right ventricular myocardial performance index and right ventricular fractional area change did not change in comparison with the baseline values in both groups. Peak systolic velocity of the lateral tricuspid annulus was decreased significantly in both groups 3 months after the operation. There were no significant intergroup differences in any echocardiographic marker of right ventricular function. Conclusions Global right ventricular function was not better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2010.02.023</identifier><identifier>PMID: 20381082</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiothoracic Surgery ; Coronary Artery Bypass - adverse effects ; Coronary Artery Bypass, Off-Pump - adverse effects ; Coronary heart disease ; Coronary Stenosis - physiopathology ; Coronary Stenosis - surgery ; Echocardiography, Doppler, Pulsed ; Echocardiography, Transesophageal ; Female ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Contraction ; Pneumology ; Prospective Studies ; Severity of Illness Index ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Switzerland ; Time Factors ; Treatment Outcome ; Ventricular Dysfunction, Right - diagnostic imaging ; Ventricular Dysfunction, Right - etiology ; Ventricular Dysfunction, Right - physiopathology ; Ventricular Dysfunction, Right - prevention & control ; Ventricular Function, Left ; Ventricular Function, Right</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2011-02, Vol.141 (2), p.361-367</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2011 The American Association for Thoracic Surgery</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c488t-77d536bceb7ec6a0c14efb55017261592e420746a572732922f46fca121121223</citedby><cites>FETCH-LOGICAL-c488t-77d536bceb7ec6a0c14efb55017261592e420746a572732922f46fca121121223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522310001674$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23842827$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20381082$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Michaux, Isabelle, MD, PhD</creatorcontrib><creatorcontrib>Filipovic, Miodrag, MD</creatorcontrib><creatorcontrib>Skarvan, Karl, MD</creatorcontrib><creatorcontrib>Bolliger, Daniel, MD</creatorcontrib><creatorcontrib>Schumann, Regina, MD</creatorcontrib><creatorcontrib>Bernet, Franziska, MD</creatorcontrib><creatorcontrib>Seeberger, Manfred D., MD</creatorcontrib><title>A randomized comparison of right ventricular function after on-pump versus off-pump coronary artery bypass graft surgery</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objectives Right ventricular dysfunction occurs very soon after conventional coronary bypass surgery with cardiopulmonary bypass and might not recover within 1 year after the operation. It has been postulated that performing coronary surgery without cardiopulmonary bypass might preserve right ventricular function. We hypothesized that right ventricular global and overall systolic functions are better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery. Methods Fifty patients scheduled for elective coronary bypass surgery were randomly assigned to conventional or off-pump surgery. Right ventricular function was assessed by means of transthoracic echocardiographic analysis the day before the operation and 3 months later. Right ventricular myocardial performance index was used as a marker of global right ventricular function, and right ventricular fractional area change was used as a marker of overall right ventricular systolic function. Peak systolic velocities of the lateral tricuspid annulus were studied to assess regional systolic function of the right ventricular free wall. Results Surgical intervention was completed according to randomization in 48 of 50 patients. Demographic and perioperative characteristics were similar in the 2 groups. Over the study period, right ventricular myocardial performance index and right ventricular fractional area change did not change in comparison with the baseline values in both groups. Peak systolic velocity of the lateral tricuspid annulus was decreased significantly in both groups 3 months after the operation. There were no significant intergroup differences in any echocardiographic marker of right ventricular function. Conclusions Global right ventricular function was not better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery.</description><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiothoracic Surgery</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary Artery Bypass, Off-Pump - adverse effects</subject><subject>Coronary heart disease</subject><subject>Coronary Stenosis - physiopathology</subject><subject>Coronary Stenosis - surgery</subject><subject>Echocardiography, Doppler, Pulsed</subject><subject>Echocardiography, Transesophageal</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Contraction</subject><subject>Pneumology</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Switzerland</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Right - diagnostic imaging</subject><subject>Ventricular Dysfunction, Right - etiology</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><subject>Ventricular Dysfunction, Right - prevention & control</subject><subject>Ventricular Function, Left</subject><subject>Ventricular Function, Right</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkl2r1DAQhoMonnX1FwiSG_Gqaz7apr1QOBz8ggNeqOBdSNNkTW2TmmkX11_vrLsqeCMMhEyedzLzMoQ85mzHGa-fD7thsQfYCYYZJjDkHbLhrFVF3VSf75INY0IUlRDyijwAGBhjivH2PrkSTDacNWJDvl_TbGKfpvDD9dSmaTY5QIo0eZrD_stCDy4uOdh1NJn6Ndol4Kvxi8s0xWJepxmRDCugxJ_vNuUUTT5SkxE70u44GwC6zyijsOY9Jh-Se96M4B5dzi359PrVx5u3xe37N-9urm8LWzbNUijVV7LurOuUs7VhlpfOd1XFuBI1r1rhSsFUWZtKCSVFK4Qva28NFxwDR9-SZ-e6c07fVgeLngJYN44murSCbspKtliiRVKeSZsTQHZezzlMOIbmTJ8c14P-5bg-Oa6ZwJCoenKpv3aT6_9ofluMwNMLYMCa0aPdNsBfTjalaLD3LXlx5hy6cQgua7DBRev6kJ1ddJ_Cfxp5-Y_ejiEG_PKrOzoY0pojGq25BhToD6flOO0Gx7XgtSrlT4uWtjk</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Michaux, Isabelle, MD, PhD</creator><creator>Filipovic, Miodrag, MD</creator><creator>Skarvan, Karl, MD</creator><creator>Bolliger, Daniel, MD</creator><creator>Schumann, Regina, MD</creator><creator>Bernet, Franziska, MD</creator><creator>Seeberger, Manfred D., MD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>A randomized comparison of right ventricular function after on-pump versus off-pump coronary artery bypass graft surgery</title><author>Michaux, Isabelle, MD, PhD ; Filipovic, Miodrag, MD ; Skarvan, Karl, MD ; Bolliger, Daniel, MD ; Schumann, Regina, MD ; Bernet, Franziska, MD ; Seeberger, Manfred D., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c488t-77d536bceb7ec6a0c14efb55017261592e420746a572732922f46fca121121223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiothoracic Surgery</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary Artery Bypass, Off-Pump - adverse effects</topic><topic>Coronary heart disease</topic><topic>Coronary Stenosis - physiopathology</topic><topic>Coronary Stenosis - surgery</topic><topic>Echocardiography, Doppler, Pulsed</topic><topic>Echocardiography, Transesophageal</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Contraction</topic><topic>Pneumology</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Switzerland</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Right - diagnostic imaging</topic><topic>Ventricular Dysfunction, Right - etiology</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><topic>Ventricular Dysfunction, Right - prevention & control</topic><topic>Ventricular Function, Left</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Michaux, Isabelle, MD, PhD</creatorcontrib><creatorcontrib>Filipovic, Miodrag, MD</creatorcontrib><creatorcontrib>Skarvan, Karl, MD</creatorcontrib><creatorcontrib>Bolliger, Daniel, MD</creatorcontrib><creatorcontrib>Schumann, Regina, MD</creatorcontrib><creatorcontrib>Bernet, Franziska, MD</creatorcontrib><creatorcontrib>Seeberger, Manfred D., MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Michaux, Isabelle, MD, PhD</au><au>Filipovic, Miodrag, MD</au><au>Skarvan, Karl, MD</au><au>Bolliger, Daniel, MD</au><au>Schumann, Regina, MD</au><au>Bernet, Franziska, MD</au><au>Seeberger, Manfred D., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomized comparison of right ventricular function after on-pump versus off-pump coronary artery bypass graft surgery</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>141</volume><issue>2</issue><spage>361</spage><epage>367</epage><pages>361-367</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objectives Right ventricular dysfunction occurs very soon after conventional coronary bypass surgery with cardiopulmonary bypass and might not recover within 1 year after the operation. It has been postulated that performing coronary surgery without cardiopulmonary bypass might preserve right ventricular function. We hypothesized that right ventricular global and overall systolic functions are better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery. Methods Fifty patients scheduled for elective coronary bypass surgery were randomly assigned to conventional or off-pump surgery. Right ventricular function was assessed by means of transthoracic echocardiographic analysis the day before the operation and 3 months later. Right ventricular myocardial performance index was used as a marker of global right ventricular function, and right ventricular fractional area change was used as a marker of overall right ventricular systolic function. Peak systolic velocities of the lateral tricuspid annulus were studied to assess regional systolic function of the right ventricular free wall. Results Surgical intervention was completed according to randomization in 48 of 50 patients. Demographic and perioperative characteristics were similar in the 2 groups. Over the study period, right ventricular myocardial performance index and right ventricular fractional area change did not change in comparison with the baseline values in both groups. Peak systolic velocity of the lateral tricuspid annulus was decreased significantly in both groups 3 months after the operation. There were no significant intergroup differences in any echocardiographic marker of right ventricular function. Conclusions Global right ventricular function was not better preserved 3 months after off-pump surgery than after conventional coronary bypass surgery.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>20381082</pmid><doi>10.1016/j.jtcvs.2010.02.023</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiology. Vascular system Cardiothoracic Surgery Coronary Artery Bypass - adverse effects Coronary Artery Bypass, Off-Pump - adverse effects Coronary heart disease Coronary Stenosis - physiopathology Coronary Stenosis - surgery Echocardiography, Doppler, Pulsed Echocardiography, Transesophageal Female Heart Humans Male Medical sciences Middle Aged Myocardial Contraction Pneumology Prospective Studies Severity of Illness Index Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Switzerland Time Factors Treatment Outcome Ventricular Dysfunction, Right - diagnostic imaging Ventricular Dysfunction, Right - etiology Ventricular Dysfunction, Right - physiopathology Ventricular Dysfunction, Right - prevention & control Ventricular Function, Left Ventricular Function, Right |
| title | A randomized comparison of right ventricular function after on-pump versus off-pump coronary artery bypass graft surgery |
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