Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3122
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Objective: This study evaluated the incidence, causes, and predictors of intraoperative conversion from off-pump coronary artery bypass grafting (OPCAB) to on-pump coronary artery bypass grafting (ONCAB), identifying risk factors to improve surgical planning.
Methods: This retrospective case-control study included patients who underwent OPCAB at the Peshawar Institute of Cardiology, Peshawar, Pakistan, between December 8, 2021, and December 7, 2023. Among 714 patients, 27 (3.78%) required conversion to ONCAB. For comparison, 108 (15.1%) controls were randomly selected from those who completed OPCAB successfully. Preoperative and intraoperative data were analyzed, and logistic regression identified predictors of conversion.
Results: The most frequent cause of conversion was hemodynamic instability, which occurred in 18 (66.67%) cases. Persistent hypotension and ST-segment changes lasting approximately 10-20 minutes were primary indicators before conversion, highlighting the need for close intraoperative monitoring. Left main coronary artery stenosis of 50%-70% emerged as the only independent predictor of conversion (odds ratio (OR) 7.60, 95% CI: 2.91-19.83, p < 0.001). This study emphasizes the importance of robust patient selection criteria, especially for cases with borderline coronary anatomy.
Conclusion: Hemodynamic instability and moderate left main coronary artery stenosis significantly contribute to OPCAB-to-ONCAB conversion. Enhanced preoperative imaging and hemodynamic management protocols can potentially reduce conversion rates, improving surgical outcomes.
Download full-text PDF |
Source |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624428 | PMC |
http://dx.doi.org/10.7759/cureus.73177 | DOI Listing |
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