Læknablaðið - 15.09.2012, Blaðsíða 16

RANNSÓKN
Þakkir
Þakkir fær Gunnhildur Jóhannsdóttir fyrir aðstoð við leit að
sjúkraskrám, Sigurlaug Magnúsdóttir fyrir upplýsingar um
fjölda kransæðavíkkana og Sigurjón H. Ólafsson fyrir yfirlestur.
Rannsóknin var styrkt af Vísindasjóði Landspítala, Minningarsjóði
Bengt Scheving Thorsteinssonar, Rannsóknarsjóði Háskóla
íslands og Minningarsjóði Helgu Guðmundsdóttur og Sigurliða
Kristjánssonar.
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ENGUSH SUMMARY
Outcome of myocardial revascularisation in lceland
Sigurjonsson H12, Helgadottir S', Oddsson S1, Sigurdsson M1-2, Geirsson A1, Arnorsson Th1, Gudbjartsson T12
Introduction: In lceland over 3500 coronary artery bypass operations
have been performed, both On-Pump, using cardiopulmonary bypass
and Off-Pump, surgery on a beating heart. The aim was to study their
outcome.
Material and methods: This was a retrospective study on 720
consecutive patients who underwent surgical revascularisation at
Landspítali -The National University Hospital of lceland between 2002-
2006; 513 On-Pump and 207 Off-Pump patients. Complications and
operative mortality (<30 days) were compared between the groups and
predictors of survival identified using multivariate analysis.
Results: The number of males was significantly higher in the On-Pump
group, but other risk factors of coronary artery disease, including age
and high body mass index, were comparable, as were the number of
distal anastomoses and EuroSCORE. The Off-Pump procedure took
25 minutes longer on average and chest tube output was significantly
increased, but the amount of transfusions administered was similar.
The rate of minor complications was higher in the On-Pump group. Of
the major complications, stroke rates were similar in both groups (2%)
but the rate of reoperation for bleeding was higher in the On-Pump
group. Mean length of hospital stay was one day longer for On-Pump
patients but operative mortality was similar for both groups (4% vs.
3%, p=0.68) as was 5 year survival (92% in both groups). In multivariate
analysis both EuroSCORE and age predicted outcome of operative
mortality and long term survival but type of surgery (On-Pump vs. Off-
Pump) was not a predictive variant.
Conclusions: Outcome of myocardial revascularisation in lceland
is good as regards operative mortality and long term survival. This
applies to both conventional On-Pump and Off-Pump procedures.
Key words: Coronary artery bypass graft (CABG), off-pump coronary artery bypass surgery (OPCAB), complications, operative mortatity, survival, population based.
Correspondence: Tómas Guðbjartsson, tomasgud@iandspitaii.is
'Department of Cardiothoracic Surgery, Landspitali - The National University Hospital of lceland, *Facuity of Medicine, University of lceland, Reyk/avik, lceland
456 LÆKNAblaðið 2012/98