Pre-operative haemodynamics
Operative data On- or off-pump
Pre-op haemodynamics
% of isolated CABG
n
A total of 126 isolated CABG procedures performed at RNSH used the heart-lung bypass machine (i.e. were ‘on-pump’), representing 73.7% of all isolated CABG cases. This is in comparison to 45 isolated CABG cases (26.3%) that did not use the heart-lung bypass machines (i.e. were ‘off-pump’) (Table 17).
Ejection fraction <50%
34
19.9
LVEF median (IQR)
56 (50, 61)
On- or off-pump
% of isolated CABG
n
LVEF estimate
On-pump
126
73.7
Normal (>60%)
65
38.0
Off-pump
45
26.3
Mild impairment (46-60%)
72
42.1
Table 17. On- and off-pump proportions
Moderate impairment (30-54%)
27
15.8
Severe impairment (<30%)
7
4.09
Table 18 summarises the use of bilateral mammary arteries, number of arterial grafts, and total number of grafts performed in the two methods of CABG. These factors have been associated with better long term outcomes.
Left main disease >50%
43
25.1
Number of diseased coronary systems 1
On- vs off- pump
Total LIMA n (%)
RIMA n (%)
Number of distal
Number of distals using arterial conduits median (IQR)
Number of distals using radial conduits median (IQR)
Number of distals using vein conduits median (IQR)
6
3.51
anastomses median (IQR)
2
37
21.6
3
128
74.8
116 (92.1)
On-pump 126
8 (6.3) 3 (2, 3.8)
1 (1, 2)
1 (1, 1)
2 (1, 2)
Table 16. Pre-operative haemodynamic status breakdown for isolated CABG cases
44 (97.8)
29 (64.4)
Off-pump 45
3 (3, 4)
3 (1, 3)
1 (1, 2)
2 (1, 2.2)
Table 18. Conduit selection on- or off-pump comparisons
Ischaemic time Perfusion time refers to the amount of time a patient spends on the heart-lung bypass machine. Cross clamp time is the length of time the heart is not perfused but protected by cardioplegia and hypothermia during the operative case.
Ichaemic time variables
On-pump median (IQR)
Cross clamp time (mins)
53.5 (42, 68)
Perfusion time (mins)
91 (71.25, 117.5)
Table 19. Summary of ischaemic time variables. Values are expressed as medians and interquartile ranges (IQR).
32
33
Cardiac Surgery Annual Report 2021
Cardiac Surgery Annual Report 2021
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