Off-pump coronary bypass for patients with concomitant malignancy.

摘要

BACKGROUND: The effectiveness and advantages of off-pump coronary artery bypass (OPCAB) for patients with concomitant malignant neoplastic disorders were analyzed. METHODS AND RESULTS: The study group comprised 368 patients who underwent OPCAB and of them 18 had concomitant malignant neoplastic disease: 14 with solitary malignant disease, 4 with low-grade lymphocytic malignancies. The age of the patients ranged from 49 to 72 years (mean 61). The mean left ventricular ejection fraction was 46.4% (range: 35-60%) and the mean number of grafts was 2.4+/-0.9. The left internal mammary artery was used in 12 patients (75%). Mean blood loss was 420+/-64 ml and the average requirement for blood transfusion was 1.1+/-0.2 units. There was no postoperative infection or in-hospital mortality. The mean length of hospital stay was 6.4+/-1.3 days. Mid-term follow-up was completed (100%) and the mean follow-up period was 22.6+/-4.1 months. All patients with a solitary malignancy underwent subsequent non-cardiac surgerywith a mean interval of 16.4+/-3.3 days. Mid-term survival was 83.4%. Freedom from late cardiac events (angina, myocardial infarction, percutaneous transluminal coronary angioplasty) that required hospital admission was 92.3%. CONCLUSION: These results support the effectiveness of OPCAB, mostly as a bridge to safe non-cardiac surgery that can be crucial for long-term survival.