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Revascularization of dysfunctional but viable myocardium needs to be careful about postoperative rhythm disturbance after off-pump coronary artery bypass grafting: an uncontrolled observational retrospective clinical study
Med Biol Sci Eng 2018;1(2):39-44
Published online July 31, 2018
© 2018 Medical Biological Science and Engineering.

Seong Hyop Kim1, Seung Zhoo Yoon2 , Kyung Hee Koh2, Jung Man Lee3

1Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, 2Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, 3Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
Correspondence to: Seung Zhoo Yoon
Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea
Tel: +82-2-920-5632
Fax: +82-2-929-2936
E-mail: yoonsz70@gmail.com
ORCID: https://orcid.org/0000-0002-9816-3531
Received April 30, 2018; Revised May 12, 2018; Accepted May 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Myocardial viability is one of important factors to determine clinical outcomes after off-pump coronary artery bypass grafting. We hypothesized that the revascularization of nonviable myocardium might show the different features of myocardial reperfusion postoperatively as compared with viable myocardium. Patients who underwent off-pump coronary artery bypass grafting for 2 years were retrospectively reviewed. Viable group (V group, n=159) and nonviable group (N group, n=24) were divided using preoperative single photon emission-computed tomography. The postoperative complication was evaluated by 1) occurrence of rhythm disturbance (atrial fibrillation/flutter or ventricular tachycardia), 2) use of continuous epinephrine, and 3) intra-aortic balloon pump insertion. Intubation time and intensive care unit (ICU) stay were also documented. Demographic data (gender, age, ejection fraction, and New York Heart Association [NYHA] classification) showed no difference. N group showed higher incidence of rhythm disturbance. Although intubation time showed no difference, ICU stay of N group was longer than V group. Revascularization of non-myocardium was associated with higher incidence of rhythm disturbance and longer ICU stay as compared with viable myocardium.
Keywords : Coronary artery bypass; Myocardial reperfusion; Postoperative complications
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