Al Masum Ziaul HaqueNational Institute of Cardiovascular Diseases, Bangladesh
Title: Evaluation of mortality and morbidity in off-pump coronary artery bypass grafting versus coronary artery bypass grafting with cardiopulmonary bypass in diabetic patient study at NICVD
Abstract: Every operation results in hyperglycemia due to the stress response associated with them. CPB is associated with an increased incidence of hyperglycemia. Many studies have shown that diabetes is associated with increased morbidity and mortality in CABG surgery. We reviewed the CABG experience to determine the impact of outcome in diabetic patients with CABG surgery in On-pump CABG versus coronary artery bypass without cardiopulmonary bypass In this study we have tried to evaluate the short-term outcome in terms of post-operative morbidity and mortality of coronary artery bypass grafting in diabetes patient with or without cardiopulmonary bypass. Method- January 2008 to December 2010. National institute of cardiovascular diseases and hospital department of cardiac surgery, About 80 Adult diabetic patients undergoing isolated CABG both on-pump and OPCAB will be divided into 2 groups – 40 patients in each group. To evaluate both preoperative, perioperative and postoperative outcomes and compare Off-pump and On pump groups in hospital outcomes Mortality and morbidity.
Result: Diabetic patients undergoing coronary artery bypass grafting without cardiopulmonary bypass had fewer complications, including neurological dysfunction (7.5% versus 10.0%, p = 0.1), and reduced incidence of prolonged ventilation (7.5% versus 12.5%, p = 0.709), atrial fibrillation (15.0% versus 20.0%, p = 0.002), and renal dysfunction (10.0% versus 17.5%, p = 0.556). In the postoperative period, 70% of patients in the OPCAB group did not experience any cardiac events whereas 30% of patients developed myocardial infarction, 5% had a cardiac arrest and 7.5% had low output syndrome. In on-pump group 65% of patients had no cardiac events whereas 35% of patients developed one or more cardiac events. Of the 20% of patients who developed atrial fibrillation, 2.5% developed myocardial infarction, 2.5% develop cardiac arrest and 10% had low output syndrome. 2.5% of patients developed both atrial fibrillation and low output.
Conclusion: Diabetes Patients undergoing coronary artery bypass grafting without cardiopulmonary bypass compared with those having coronary artery bypass grafting with cardiopulmonary bypass had higher mean predicted mortalities and morbidity is seen in hospital.
To be updated