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Outcomes of single institutional experience with Single Cross-Clamp technique
Journal of Cardiothoracic Surgery volume 10, Article number: A174 (2015)
Minimizing cardiac surgery related mortality and furthermore morbidity remains at the center of patient focused care and quality improvement. We present our experience with single cross-clamp technique following coronary artery bypass graft surgery (CABG) with or without aortic valve replacement (AVR).
We hypothesize that a single cross clamp technique can improve survival whilst reducing associated morbidity.
All clinical data were prospectively collected with the study design and analysis being retrospective in nature. A single surgeon's procedures were included for the period October 2007 to January 2014
712 (male 77.5%) patients were operated on, with 609 (85.54%) being isolated CABG and 103 (14.46%) combined CABG with AVR. Average age in isolated CABG and combined groups were 66 and 73 years respectively. Average additive EuroScores were 3.5 and 7.29. 21.6% cases were performed by trainee or staff grade surgeon.
In hospital mortality was 0.16% in isolated CABG and 0% in CABG with AVR group. Postoperative complications in isolated CABG group included reoperation for bleeding or tamponade (2.13%), renal impairment requiring temporary haemodialysis (0.82%), and respiratory failure requiring reintubation (0.65%). We did not experience any cerebrovascular events. In the combined CABG with AVR group we experienced reoperation for bleeding or tamponade (2.91%), respiratory failure requiring reintubation (1.94%), and cerebrovascular events (1.94%).
Kaplan Meier survival at 1, 3, and 5 years was 98.35%, 95.85% and 92.61% (isolated CABG), and 96%, 86.4% and 79.4% (combined CABG with AVR).
Our preliminary study has demonstrated outcomes comparable to our nationally reported outcomes for the same time period. Single cross clamp technique for CABG with or without AVR is a safe and reproducible technique.
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Rajnish, R., Rose, D., Massey, J. et al. Outcomes of single institutional experience with Single Cross-Clamp technique. J Cardiothorac Surg 10, A174 (2015) doi:10.1186/1749-8090-10-S1-A174
- Coronary Artery Bypass Graft
- Respiratory Failure
- Hospital Mortality
- Aortic Valve Replacement
- Cerebrovascular Event