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Masud Malik W, Ullah K, Gohar MA, Siddique S, Hameed H, Mansoor Tariq M, Iqbal A, Nisar M, Ur Rahman U, Abdul Haseeb M, Khan FR. Predictors and Causes of Intraoperative Conversion From Off-Pump to On-Pump Coronary Artery Bypass: A Retrospective Study. Cureus 2024; 16:e73177. [PMID: 39650970 PMCID: PMC11624428 DOI: 10.7759/cureus.73177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2024] [Indexed: 12/11/2024] Open
Abstract
OBJECTIVE This study evaluated the incidence, causes, and predictors of intraoperative conversion from off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB), identifying risk factors to improve surgical planning. METHODS This retrospective case-control study included patients who underwent OPCAB at the Peshawar Institute of Cardiology, Peshawar, Pakistan, between December 8, 2021, and December 7, 2023. Among 714 patients, 27 (3.78%) required conversion to ONCAB. For comparison, 108 (15.1%) controls were randomly selected from those who completed OPCAB successfully. Preoperative and intraoperative data were analyzed, and logistic regression identified predictors of conversion. RESULTS The most frequent cause of conversion was hemodynamic instability, which occurred in 18 (66.67%) cases. Persistent hypotension and ST-segment changes lasting approximately 10-20 minutes were primary indicators before conversion, highlighting the need for close intraoperative monitoring. Left main coronary artery stenosis of 50%-70% emerged as the only independent predictor of conversion (odds ratio (OR) 7.60, 95% CI: 2.91-19.83, p < 0.001). This study emphasizes the importance of robust patient selection criteria, especially for cases with borderline coronary anatomy. CONCLUSION Hemodynamic instability and moderate left main coronary artery stenosis significantly contribute to OPCAB-to-ONCAB conversion. Enhanced preoperative imaging and hemodynamic management protocols can potentially reduce conversion rates, improving surgical outcomes.
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Affiliation(s)
| | - Kifayat Ullah
- Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, PAK
| | | | - Sobia Siddique
- Cardiac Surgery, Armed Forces Institute of Cardiology, Rawalpindi, PAK
| | - Hira Hameed
- Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, PAK
| | | | - Amir Iqbal
- Cardiac Surgery, Peshawar institute of Cardiology, Peshawar, PAK
| | - Muhammad Nisar
- Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, PAK
| | - Ubaid Ur Rahman
- Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, PAK
| | | | - Fahad R Khan
- Interventional Cardiology, Peshawar Institute of Cardiology, Peshawar, PAK
- General Cardiology, Lady Reading Hospital, Peshawar, PAK
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Kunigo T, Oikawa R, Sonoda T, Nomura M. No association between pulmonary artery catheter use and postoperative complications in off-pump coronary artery bypass grafting: a single-center pilot study. THE JOURNAL OF CARDIOVASCULAR SURGERY 2023; 64:541-547. [PMID: 37458732 DOI: 10.23736/s0021-9509.23.12710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND A pulmonary artery catheter is often used in cardiac surgery despite its uncertain effectiveness. The aim of this pilot study was to investigate the associations between the use of a pulmonary artery catheter and clinical outcomes in off-pump coronary artery bypass grafting. METHODS Patients over 20 years of age who had undergone off-pump coronary artery bypass grafting between December 2018 and November 2021 were enrolled in this single-center retrospective pilot study. The propensity score of pulmonary artery catheterization was calculated. Multivariate analysis including the propensity score as a covariate was performed to assess clinical outcomes. The primary outcome was the composite outcome of in-hospital death, unplanned intraoperative conversion to cardiopulmonary bypass, resuscitated cardiac arrest, mechanical circulatory support, myocardial infarction, stroke, new initiation of renal replacement therapy, inhaled nitric oxide, re-intubation and tracheostomy. RESULTS Among the 315 patients who were enrolled, 298 were included in the final analysis. A pulmonary artery catheter was inserted in 131 patients. There were 50 patients with the composite outcome including two in-hospital deaths. Multivariate logistic regression analysis showed that pulmonary artery catheterization was not significantly related to the composite outcome. Clinical outcomes worsened significantly as the number of anastomoses increased (odds ratio: 1.450, 95% confidence interval: 1.040-2.040, P=0.029). CONCLUSIONS Pulmonary artery catheterization did not improve the clinical outcomes in off-pump coronary artery bypass grafting in this pilot study.
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Affiliation(s)
- Tatsuya Kunigo
- School of Medicine, Department of Anesthesiology, Sapporo Medical University, Sapporo, Japan -
- School of Medicine, Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan -
| | - Risa Oikawa
- School of Medicine, Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomoko Sonoda
- Department of Public Health, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Minoru Nomura
- School of Medicine, Department of Anesthesiology, Tokyo Women's Medical University, Tokyo, Japan
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Suwalski G, Galanty M, Degórska B, Sterna J, Frymus J, Baranski M, Trębacz P, Janczak D, Lepak-Kuc S, Jakubowska M. Rapid cardiac ischemia detection with an epicardial graphene probe. Front Cardiovasc Med 2023; 10:1111651. [PMID: 37424902 PMCID: PMC10323424 DOI: 10.3389/fcvm.2023.1111651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction In this study, a new probe was designed to enable electrocardiography of a rotated heart during cardiac surgery when skin electrodes became non-functional. This probe adhered non-invasively to the epicardium and collected the ECG signal independently from the position of the heart. The study compared the accuracy of cardiac ischemia detection between classic skin and epicardial electrodes in an animal model. Methods Using six pigs, an open chest model was devised with cardiac ischemia induction by coronary artery ligation in two non-physiologic heart positions. Both the accuracy and the time of detection of electrocardiographic symptoms of acute cardiac ischemia were compared between skin and epicardial methods of signal collection. Results Heart rotation to expose either the anterior or the posterior wall resulted in a distortion or loss of the ECG signal collected by skin electrodes after coronary artery ligation, standard skin ECG monitoring did not reveal any ischemia symptoms. Attachment of an epicardial probe on the anterior and posterior walls helped in the recovery of the normal ECG wave. After ligation of the coronary artery, the epicardial probes recorded cardiac ischemia within 40 s. Discussion This study highlighted the effectiveness of ECG monitoring with epicardial probes in a rotated heart. It can be concluded that epicardial probes can detect the presence of acute ischemia of a rotated heart when skin ECG monitoring becomes ineffective.
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Affiliation(s)
- Grzegorz Suwalski
- Department of Cardiac Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Marek Galanty
- Department of Small Animal Diseases and Clinic, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Beata Degórska
- Department of Small Animal Diseases and Clinic, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Jacek Sterna
- Department of Small Animal Diseases and Clinic, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Jan Frymus
- Department of Small Animal Diseases and Clinic, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Mikhal Baranski
- Department of Small Animal Diseases and Clinic, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Piotr Trębacz
- Department of Small Animal Diseases and Clinic, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Warsaw, Poland
| | - Daniel Janczak
- Faculty of Mechatronics, Warsaw University of Technology, Warsaw, Poland
| | - Sandra Lepak-Kuc
- Faculty of Mechatronics, Warsaw University of Technology, Warsaw, Poland
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Guan T, Qiu Z, Su M, Yang J, Tang Y, Jiang Y, Yao D, Lai Y, Li Y, Liu C. Cardiovascular Death Risk in Primary Central Nervous System Lymphoma Patients Treated With Chemotherapy: A Registry-Based Cohort Study. Front Oncol 2021; 11:641955. [PMID: 34046345 PMCID: PMC8147725 DOI: 10.3389/fonc.2021.641955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/14/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose To study the cardiovascular death (CVD) risk in primary central nervous system lymphoma (PCNSL) patients with chemotherapy. Methods We obtained 2,020 PCNSL participants and 88,613 non-central nervous system lymphoma (NCNSL) participants with chemotherapy from Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015. A 1:3 propensity score matching (PSM) was used to reduce the imbalance between PCNSL participants with and without chemotherapy, as well as the imbalance between PCNSL and NCNSL participants with chemotherapy. Competing risks regressions were conducted to evaluate the independent influence of chemotherapy on CVD. Results After 1:3 PSM, the CVD risk in PCNSL patients with chemotherapy was lower than those without chemotherapy [decreased 53%, adjusted HR, 0.469 (95% CI, 0.255–0.862; P = 0.015)] as well as NCNSL patients with chemotherapy [decreased 36%, adjusted HR in model 1, 0.636 (95% CI, 0.439–0.923; P = 0.017)]. The CVD risk of chemotherapy decreased in PCNSL patients with age at diagnosis >60 years old [adjusted HR, 0.390 (95% CI, 0.200–0.760; P = 0.006)], and those patients diagnosed at 2010 to 2015 [adjusted HR, 0.339 (95% CI, 0.118–0.970; P = 0.044)]. Conclusion PCNSL patients with chemotherapy are associated with lower CVD risk. Our findings may provide new foundations for that chemotherapy is the first-line treatment for PCNSL patients, according to a cardiovascular risk perspective.
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Affiliation(s)
- Tianwang Guan
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.,Department of Cardiology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China.,Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zicong Qiu
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.,Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Miao Su
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.,Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Jinming Yang
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.,Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Yongshi Tang
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Yanting Jiang
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Dunchen Yao
- Department of Oncology, Guiqian International General Hospital, Guiyang, China
| | - Yanxian Lai
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.,Department of Cardiology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
| | - Yanfang Li
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cheng Liu
- Department of Cardiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.,Department of Cardiology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China
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Jiang R, Wang Y, Pang L, Sun X, Chu X, Wang F, Huang J. Feasibility of off-pump coronary artery grafting for patients with impaired left ventricular ejection fraction: A retrospective cohort study from a single institutional database. J Card Surg 2021; 36:1935-1942. [PMID: 33665893 DOI: 10.1111/jocs.15462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/05/2021] [Accepted: 02/14/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Despite substantial advances in surgical practice, the management of patients with impaired left ventricular ejection fraction (LVEF) remains challenging. Furthermore, evidence on the outcomes of off-pump coronary artery bypass (OPCAB) surgery in this population is inconsistent. We conducted the present study to compare the short- and long-term outcomes of OPCAB in patients with different ejection fractions. METHODS This retrospective cohort study used data from the Hua-Shan Cardiac Surgery and included consecutive patients aged ≥ 18 years who underwent OPCAB procedures during 2016-2019. The patients included in the study were followed up until death or the end of data collection. Patients with different ejection fractions were matched 1:2 using propensity score matching. Factors associated with short-term outcomes were determined using logistic regression, and Kaplan-Meier survival analyses for the differences in all-cause death were generated. RESULTS The two propensity score matched groups consisted of 40 left ventricular dysfunction (LVD) and 80 normal left ventricular function (NLVF) patients. No significant intergroup differences were observed in the postoperative outcomes for the occurrence of left heart failure (22.5% in LVD vs. 5.0% in NLVF, p = .009). Age (odds ratio = 1.11, 95% confidence interval = 1.04-1.18) but not the preoperative LVEF was shown to be a strong predictor of short-term events in logistic regression analyses. Kaplan-Meier curves displayed similar freedom from all-cause death (p = .119) or cardio-death (p = .092) between groups. CONCLUSION The immediate postoperative outcomes and long-term outcomes were similar between the groups, indicating that OPCAB is a safe and effective choice for patients with LVD.
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Affiliation(s)
- Rongrong Jiang
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Yiqing Wang
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Liewen Pang
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Xiaotian Sun
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Xianglin Chu
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Fangrui Wang
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Jiechun Huang
- Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai, PR China
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Preoperative right ventricular dysfunction requires high vasoactive and inotropic support during off-pump coronary artery bypass grafting. Gen Thorac Cardiovasc Surg 2021; 69:934-942. [PMID: 33389573 PMCID: PMC7778867 DOI: 10.1007/s11748-020-01557-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/16/2020] [Indexed: 11/07/2022]
Abstract
Objectives The association of preoperative RV function with hemodynamics during OPCAB or emergency conversion is not clear. The aim of this study was to investigate the association of vasoactive-inotropic score with tricuspid annular plane systolic excursion and tricuspid regurgitation in off-pump coronary artery bypass grafting, and to calculate the optimal cut-off value of tricuspid annular plane systolic excursion to predict emergency conversion to cardiopulmonary bypass. Methods Patients over 20 years of age who had undergone off-pump coronary artery bypass grafting between April 2015 and March 2020 were enrolled in this study. We retrospectively assessed the association of intraoperative maximum “vasoactive-inotropic score”, a weighted sum of various inotropes and vasoconstrictors, with tricuspid annular plane systolic excursion and tricuspid regurgitation. A receiver operating characteristic curve of conversion on tricuspid annular plane systolic excursion was also constructed. Results 135 patients were included in final analysis. Conversion was performed in 10 cases. Multiple regression analysis showed that tricuspid annular plane systolic excursion, mild or more tricuspid regurgitation and experienced surgeon were significantly related to vasoactive-inotropic score. The receiver operating characteristic curve to predict conversion by tricuspid annular plane systolic excursion showed an optimal cut-off value of 15.0 mm and area under the curve of 0.808. Conclusions Tricuspid annular plane systolic excursion and tricuspid regurgitation were associated with vasoactive-inotropic score in off-pump coronary artery bypass grafting. The optimal cut-off value of tricuspid annular plane systolic excursion to predict emergency conversion was 15 mm.
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Chakravarthy M, Prabhakumar D, Patil TA, George A, Jawali V. Conversion during off-pump coronary artery bypass graft surgery: A case-control study. Ann Card Anaesth 2020; 22:18-23. [PMID: 30648674 PMCID: PMC6350426 DOI: 10.4103/aca.aca_227_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objectives: Off pump coronary artery bypass (OPCAB) surgery is carried out as an alternative to conventional coronary artery bypass grafting using cardiopulmonary bypass (CPB). At times ‘conversion’ to CPB may be required to bail out a situation resulting from acute decompensation of the heart. It is reported that such conversion carries significant mortality risk. Since we conduct coronary revascularization by OPCAB technique as the preferred technique, we conducted this study with an aim to identify the markers of adverse outcome during conversion in Indian patients. Design: Case control retrospective study. Setting: Tertiary referral center. Participants: We conducted three thousand two hundred OPAB surgeries in the period between 2013 to16. Ninety patients (3.1%) required conversion to complete the revascularization (Con version group). Twice the number of patients who underwent OPCAB surgery without conver sion were chosen as controls (Control group). Intervention: OPCAB surgery Results: Mortality in the conversion group was 5.56% in contrast to 0.06% in the controls (P = 0.01). The conversion group had higher left ventricular end diastolic pressure, incidence of endarterectomy, and intra-aortic balloon counter pulsation requirement. Female gender was also predictive of conversion. The total chest drain, duration of ventilation, ICU stay and hospital stay were also higher in the conversion group. Conversion was associated with 9.47 times the odds for mortality. Conclusion: Conversion during OPCAB is associated with significantly increased mortality. Female gender, increased left ventricular end diastolic pressure and preoperative requirement of Intra-aortic balloon are markers of increased risk of mortality when converted.
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Affiliation(s)
- Murali Chakravarthy
- Departments of Anesthesia, Critical Care and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Dattatreya Prabhakumar
- Departments of Anesthesia, Critical Care and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - T A Patil
- Departments of Anesthesia, Critical Care and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Antony George
- Departments of Anesthesia, Critical Care and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Vivek Jawali
- Departments of Cardiovasular Sciences, Fortis Hospital, Bengaluru, Karnataka, India
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Wang W, Wang Y, Piao H, Li B, Wang T, Li D, Zhu Z, Xu R, Liu K. Early and Medium Outcomes of On-Pump Beating-Heart versus Off-Pump CABG in Patients with Moderate Left Ventricular Dysfunction. Braz J Cardiovasc Surg 2019; 34:62-69. [PMID: 30810676 PMCID: PMC6385843 DOI: 10.21470/1678-9741-2018-0207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 08/24/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study aims to compare the early and medium outcomes of on-pump beating-heart (OPBH) coronary artery bypass grafting (CABG) and off-pump CABG (OPCABG) in patients with left ventricular ejection fraction (LVEF) between 30% and 40%. METHODS This is a retrospective study of ischemic heart disease patients with LVEF between 30% and 40% who underwent surgical revascularization from January 2013 to December 2017. Patients were divided into OPBH group (n=44) and OPCABG group (n=68), according to the surgical method. Clinical material with early and medium outcomes were investigated and compared between these groups. RESULTS The two groups had similar baseline. Two OPBH patients and 3 OPCABG patients died in the hospital, which had no statistical significance (P>0.05). OPBH patients received a greater number of grafts (3.74±0.84) and presented more improved LVEF (45.92±7.11%) than OPCABG patients (3.36±0.80) and (42.81±9.29%), respectively, which had statistical significance (P<0.05). An increased amount of drainage during the first 12 hours was found in the OPBH group (P<0.05). Reoperation for bleeding, duration of mechanic ventilation, and other early outcomes had no statistical significance between the two groups. During the medium-time follow-up, OPBH patients showed significantly lower major adverse cardiovascular events (MACE)-free survival time (P=0.049) than OPCABG patients. CONCLUSION The OPBH technique was a safe and an acceptable alternative for surgical revascularization in patients with moderate left ventricular dysfunction which provided better mid-term MACE-free survival compared with OPCABG.
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Affiliation(s)
- Weitie Wang
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Yong Wang
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Hulin Piao
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Bo Li
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Tiance Wang
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Dan Li
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Zhicheng Zhu
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Rihao Xu
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
| | - Kexiang Liu
- Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China
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Conversion From Off-Pump Coronary Artery Bypass Grafting to On-Pump Coronary Artery Bypass Grafting. Ann Thorac Surg 2017; 104:1267-1274. [DOI: 10.1016/j.athoracsur.2017.03.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 02/14/2017] [Accepted: 03/20/2017] [Indexed: 11/21/2022]
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Calafiore AM, Prapas S, Osman A, Di Mauro M. Coronary artery bypass grafting off-pump or on-pump: another brick in the wall. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:168. [PMID: 28480204 DOI: 10.21037/atm.2017.03.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Sotirios Prapas
- Department of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece
| | - Ahmed Osman
- Department of Critical Care, Cairo University, Giza, Egypt
| | - Michele Di Mauro
- Department of Cardiac Surgery, University G. D'Annunzio, Chieti, Italy
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