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World Journal of Advance Healthcare Research (WJAHR)Honored the authors with best paper award, monthly based on the innovation of research work. Best paper will be selected by our expert panel.
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PROGNOSTIC IMPACT OF AORTIC- CROSS CLAMP TIME IN CORONARY ARTERY BYPASS GRAFTING SURGERY
Mahmoud Shamaly*, Mudar Abdulatif and Akil Khadam
Objective: The aim of this study is to estimate the prognostic value of aortic- cross clamping time in predicting outcomes after on-pump CABG and to identify the limits of the safe time. Patients and Methods: Retrospective Analytical Prognostic Study conducted for the period four years(January 2017- January 2020) at Tishreen University Hospital and Al-Bassel hospital in Lattakia-Syria. 318 patients who underwent on-pump CABG were included in the study. Results: Mean age was 58.8±8.6years, 74.5% were males. When the peak aortic-clamp time during CABG reached 74 min, in hospital mortality could be predicted with an area under the ROC curve of 0.69(95% CI:0.48-0.90) with a sensitivity of 71% and specificity of 64.6%. The time of CPB and operation was longer with increasing cross-clamp time(153.4±27.1 vs. 114.3±26.7, p: 0.0001) and( 5.5±0.7 vs. 4.5±0.7, p:0.01) respectively. Using bilateral internal mammary arteries and radial artery was more frequently in patients with longer cross-clamp time(p<0.05). Aortic- cross clamping time?74 min was associated with significantly increased risk of mortality( HR: 4.5; 95% CI: 0.1-12.9, P:0.0001), re –exploration due to bleeding(HR: 4.9; 95% CI: 1.3-11.2, P:0.0001), prolonged inotropic dependency(HR: 3.6; 95% CI: 1.3-6.2, P:0.003), In ICU stay (HR: 2.9; 95% CI: 0.2-9.5, P:0.002),and kidney injury(HR: 2.3; 95% CI: 0.9-5.6, P:0.01). Conclusion: Prolonged aortic- cross clamping time was associated with increased mortality and morbidity, and this effect increases with increasing this time.[Full Text Article]