Predictors of prolonged mechanical ventilation following aorta no-touch off-pump coronary artery bypass surgery

Objective: To identify parameters associated with prolonged mechanical ventilation (PMV) (> 48 h) after off-pump coronary artery bypass (OPCAB) in our patient population. Materials and methods: From February 2001 to November 2005, we operated on 1359 patients for isolated coronary revascularization with the pi-circuit technique, consisting of: (1) beating heart, (2) OPCAB, (3) aorta no-touch, (4) use of composite grafts, and (5) arterial revascularization. Results: From the total number of our patients, 1320 patients had been extubated within 48 h postoperatively (Group A) and 39 patients needed PMV (Group B). In our study we have found that PMV were associated with advanced age (64.74 +/- 9.85 Group A vs 68.43 +/- 10.03 Group B, p < 0.02) as well as higher incidence with octogenarians (4.4\% Group Avs 10.2\% Group B, p = 0.09). Patients with preoperative history of transient ischemic attacks (TIAs) or stroke were more likely to belong to Group B (1.5\% Group A vs 7.7\% Group B, p < 0.02; 2.8\% Group A vs 10.3\% Group B, p < 0.02, respectively). Preoperative intra-aortic balloon pump (IABP) insertion was associated with PMV (1.6\% Group A vs 15.4\% Group B, p < 0.0005). Unexpectedly, neither COPD nor obesity was associated with PMV (4.9\% Group Avs 7.7\% Group B, p = NS, 21.7\% Group Avs 23. 1 \% Group B, p = NS, respectively). Conclusion: In this study, PMV following aorta no-touch OPCAB was related to preoperative variables: age, octogenarians, preoperative IABP, TIA, and stroke. There was no relation between PMV and any of the operative data. (c) 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.