Abstract:
OBJECTIVES:To investigate the effects of body mass index (BMI) on early outcomes after revascularization using either on-pump or off-pump surgery. METHODS:Data for 3714 of 4314 patients who underwent surgical revascularization at our institution between 1999 and 2008 were analysed. Patients were divided into two groups [off-pump coronary artery bypass (OPCAB); n = 1958 and on-pump coronary artery bypass (ONCAB); n = 1756] and further assigned into five classes according to their BMI (underweight <20 kg/m(2), normal 20-24.99 kg/m(2), overweight 25-29.99 kg/m(2), obese 30-34.99 kg/m(2) and morbidly obese ≥35 kg/m(2)). Thirty-day mortality, occurrence of major adverse cardiac events (MACEs), occurrence of major non-cardiac adverse events (MNCAEs) and length of in-hospital stay were analysed in relation to BMI only (whole cohort analysis), to BMI and chosen surgical method (ONCAB versus OPCAB) as well as confounding factors. RESULTS:In the whole cohort analysis (n = 3714), no significant differences between BMI classes could be identified with regard to 30-day mortality (P = 0.78), MACEs (P = 0.72), MNCAEs (P = 0.45) or length of in-hospital stay (P = 0.94). With increasing BMI values, 30-day mortality tended to steadily increase (1.8% in BMI class 'underweight' vs 2.6% in BMI class 'morbidly obese'; P = 0.78), whereas MNCAEs tended to decrease with an increasing BMI (17.5% in BMI class 'underweight' vs 12.2% in BMI class 'morbidly obese'; P = 0.45). Compared with ONCAB, in patients with higher BMI values, OPCAB appeared to reduce slightly the frequency of 30-day mortality, MACEs and MNCAEs, while slightly increasing the length of in-hospital stay. Adjustment for other risk factors by covariate analysis in multiple regression models did not change the inferences drawn. CONCLUSIONS:Our study did not detect significant differences between BMI classes with regard to mortality and morbidity. However, a slight trend towards a steadily increasing short-term mortality was detectable for patients with higher BMI values. When comparing ONCAB versus OPCAB, patients with higher BMI values appeared to have a weak tendency towards a reduced short-term morbidity and mortality in favour of OPCAB.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Caliskan E,Güsewell S,Seifert B,Theusinger OM,Starck CT,Pavicevic J,Reser D,Holubec T,Plass A,Falk V,Emmert MYdoi
10.1093/icvts/ivu246subject
Has Abstractpub_date
2014-11-01 00:00:00pages
749-55issue
5eissn
1569-9293issn
1569-9285pii
ivu246journal_volume
19pub_type
杂志文章abstract:OBJECTIVES:Although deep hypothermic circulatory arrest (HCA) is routinely used to interrupt normal perfusion of the brain and prevent subsequent cerebral ischemic injury during cardiac surgery, it is associated with various forms of neurologic disturbances. Neurologic sequelae after prolonged HCA include motor, memory...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.112813
更新日期:2005-12-01 00:00:00
abstract::Cardiac haemangiomas are rare forms of cardiac tumours which can present at any age and in any cardiac location. The clinical presentations of patients vary and preoperative diagnosis of cardiac haemangiomas is usually made using echocardiography and magnetic resonance imaging (MRI). Surgical resection is the treatmen...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.237032
更新日期:2011-03-01 00:00:00
abstract::Hoarseness of voice due to recurrent laryngeal nerve palsy is an uncommon manifestation of cardiothoracic disease. Ortner's syndrome is hoarseness attributed to mechanical compression of the left recurrent laryngeal nerve in association with several cardiopulmonary disease states. We here describe a rare case of Ortne...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivx166
更新日期:2017-10-01 00:00:00
abstract::Epithelioid hemangioendothelioma (EHE) of soft tissues is a rare low-grade vascular tumour, with variable malignancy. Mediastinal localization is exceptional. We report the first case of a radically resected EHE of the azygos vein (AV). A 47-year old man presented to our institution with an asymptomatic incidental nec...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr064
更新日期:2012-01-01 00:00:00
abstract::A best evidence topic was written according to a structured protocol. The question addressed was: in patients with inoperable early-stage primary lung cancer does microwave ablation (MWA) or stereotactic ablative body radiotherapy (SBRT) achieve improved outcomes in terms of local control, recurrence, survival and com...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivz123
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:(i) To establish who is at high risk for mitral surgery. (ii) To assess the performance of minimally invasive mitral valve surgery in high-risk patients by presenting early and late outcomes and compare these with those of the non-high-risk population. METHODS:We reviewed our database of prospective data of...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw038
更新日期:2016-06-01 00:00:00
abstract::A cardiac calcified amorphous tumour (CCAT) is a rare non-neoplastic intracavitary mass with unknown causes. We describe a 32-year old male presenting with progressive dyspnoea, cough and oedemas. The transthoracic echocardiography and contrast-enhanced angio-computed tomography demonstrated a 4 × 10 cm calcified mass...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv258
更新日期:2015-12-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is cerebrospinal fluid (CSF) drainage of benefit in patients undergoing surgery on the descending thoracic aorta or thoracoabdominal aorta?' Altogether 1177 papers were found using the reported search, ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivs284
更新日期:2012-10-01 00:00:00
abstract::Patients requiring redo cardiac surgery for diseased heart valves other than mitral valves may show increased pressure gradients and reduced valve areas of previously placed mechanical mitral valves due to subvalvular pannus formation. We treated four women who had mechanical mitral valves inserted greater than or equ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw276
更新日期:2017-01-01 00:00:00
abstract::The traumatic rupture of the thoracic aorta is a severe and life-threatening entity. The incidence of penetrating trauma to the aortic arch is not known, because most patients die of haemorrhage even before they receive adequate treatment. Clinical signs of such injuries include external or internal haemorrhage, bruit...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr101
更新日期:2012-03-01 00:00:00
abstract::Ventricular catheterization in the rat is a widely deployed procedure. Current options allow a one-time catheterization procedure, introducing an error due to the inter-individual variability. Six Fischer rats underwent left ventricular catheterization through the right carotid artery, repeated seven days later via th...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2008.184119
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVES:Previous work suggests that aortic root and valve prostheses alter blood flow patterns in the ascending aorta, creating aberrant haemodynamics compared with those of healthy volunteers. Various valve designs have been proposed to better restore physiological haemodynamics. In this study, magnetic resonance i...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw173
更新日期:2016-09-01 00:00:00
abstract::Although aortic sarcomas are extremely rare, they may arise in association with a Dacron graft. Here, we report a case of an intimal sarcoma in an ascending aortic Dacron graft implanted 17 years earlier. The patient presented with multiple cerebral infarctions; clinically, a thrombus was found to cause the embolic st...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz192
更新日期:2019-12-01 00:00:00
abstract::We describe right coronary translocation as a simplified surgical procedure for right coronary artery arising from the left sinus with an intramural course. At surgery, the right coronary artery was transected, distal to the intramural segment and subsequently anastomosed to the ascending aorta above the right coronar...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2011.268888
更新日期:2011-08-01 00:00:00
abstract::We report a rare case of a saccular aneurysm of innominate artery without any apparent causative history. Although the treatment choice remains debatable, due to the poor condition of the patient, the lesion was excluded by using a balloon-expandable covered stent with a satisfactory early-term outcome. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz244
更新日期:2020-02-01 00:00:00
abstract::Minimally invasive aortic valve replacement through right anterior minithoracotomy has been shown as a reliable and interesting approach. However, the placement of a sutured valve may be challenging and time-consuming in some cases. Sutureless bioprosthesis is an elegant alternative in order to facilitate its placemen...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv319
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:Management of malignant tumours of the heart remains a poorly investigated clinical area due to the scarcity of presentations. The purpose of this series and review is to present an outline of the management emphasized by our personal experience in a regional cardiothoracic centre. METHODS:We reviewed all c...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivs350
更新日期:2012-12-01 00:00:00
abstract::A 65-year old man who had undergone right pneumonectomy for lung cancer presented with superior vena cava (SVC) syndrome due to recurrent bulky disease on follow-up after 14 months. Complete resection of the tumour was achieved, and the SVC system was reconstructed with separated double grafts. The right graft was ana...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv188
更新日期:2015-10-01 00:00:00
abstract::Abdominal compartment syndrome is a possible complication after aneurysm repair and has a high mortality rate. Although there has been an increment in patient survival rates after aneurysm repair, there has also been an increase in this entity. However, there are few data about the incidence and management of this com...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs030
更新日期:2012-06-01 00:00:00
abstract::Coronary sinus injury is a very rare complication of cardiac surgery and is usually related to coronary sinus perfusion catheter placement for retrograde cardioplegia infusion. It can be either a catheter-related perforation or high-perfusion pressure-related injury to the coronary sinus. Primary repair of the coronar...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw393
更新日期:2017-05-01 00:00:00
abstract::Aorto-oesophageal fistula (AEF) is a rare but life-threatening disease with an underlying infective aetiology that can cause serious complications. This study investigated the clinical outcomes of patients with AEF who received in situ cryopreserved aortic allograft replacement. From August 2000 to February 2011, 11 p...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivr154
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVES:There are few reports on optimal surgical approaches to bilateral pulmonary metastasis and the sequences used in the operation. The aim of this study was to evaluate the feasibility of the thoracoscopic bilateral approach to pulmonary metastasis. METHODS:From June 2006 to February 2013, 61 patients underwen...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt514
更新日期:2014-05-01 00:00:00
abstract::There is still no consensus on the optimal management to treat pediatric mediastinitis. We assessed the efficacy of continuous irrigation and vacuum-assisted closure (VAC) for mediastinitis in children. This study retrospectively reviewed 20 patients aged <5 years with mediastinitis from December 2002 to December 2009...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.235903
更新日期:2010-09-01 00:00:00
abstract::We report a technique that allows total arterial revascularization of the circumflex territory without cardiopulmonary bypass through limited thoracotomy with the radial as a composite graft. The technique includes anastomosis of the distal end of the radial artery to its more proximal part after the division of the c...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/S1569-9293(02)00113-5
更新日期:2003-03-01 00:00:00
abstract::Infective endocarditis is a life threatening disease with high mortality and morbidity, including brain infarction concomitant with intracranial hemorrhage. Generally, patients with a recent intracranial hemorrhage are believed to be a contraindication to undergo cardiac surgery with cardiopulmonary bypass. However, s...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2006.146209
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:This study aimed to investigate the morphological characteristics of the dissected thoracic aorta and brachiocephalic arteries within the Chinese population. METHODS:A retrospective analysis of computed tomography scans of 387 patients with acute Type A aortic dissection was carried out. The dimensions of t...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivy110
更新日期:2018-10-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the anterolateral or the inferior wall served as a better location for the 2nd arterial graft in a 3-system coronary artery bypass grafting procedure. In total, more than 1800 papers were found, ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1093/icvts/ivy112
更新日期:2018-10-01 00:00:00
abstract::Heart tumors are very rare neoplasms. Solitary fibrous tumors are mesenchymal neoplasms first described as pleura-based lesions. We are the first to describe the clinical symptoms, surgical technique for removal, histology, and exact location as well as medium-term follow-up of a solitary fibrous tumor in the heart. ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.108068
更新日期:2005-10-01 00:00:00
abstract::We report on a patient with Marfan syndrome who presented a Stanford type B dissection of the descending thoracic aorta in late pregnancy. After a cesarean section, the patient presented a severe obstruction of the mesenteric superior artery. An endovascular fenestration was performed (balloon and guidewire based fene...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.232124
更新日期:2010-09-01 00:00:00
abstract::Coronary artery disease in the donor heart is an established cause of early graft failure. However, identification of this before implantation is difficult. Cardiogenic shock associated with significant myocardial infarction during the early postoperative period is rare. Here, we report a case of a 42-year-old man who...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu121
更新日期:2014-09-01 00:00:00