Patients with Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Grafting: what is the choice?.

Abstract

History of chronic obstructive pulmonary disease (COPD) is considered a risk factor in patients undergoing coronary artery bypass grafting (CABG) surgery. COPD has been conventionally associated with increased operative mortality and morbidity after coronary artery bypass grafting. The aim is to study the effect of CABG technique on pulmonary function and the outcome after the surgical interference. Sixty-two patients with moderate obstructive pulmonary disease had elective isolated coronary surgery between December 2008 and February 2010. The mean age was 68 years (40 to 75 years). Patients with moderate COPD were defined according to the predicted forced expiratory volume which was 50% to79% of the predicted value. The surgical method for the patients with chronic obstructive pulmonary disease (COPD) were off-pump in 31 patients (group 1), the same number underwent on-pump heart surgery (group 2). Smoking patients were 34 cases (54.84%) of the total population, all of the Off pump patients were smokers. The most evident respiratory morbidity was atelectasis that developed in three patients from (group 2) and two patient from (group 1) which was statistically non significant. The total ventilation hours were significantly different from the off pump (631 hours, averaged 20.35), than the on-pump group (1339 hours, averaged 43.19). Low cardiac output developed in eight patients in the on-pump group and five patients in off pump group with non significant difference. We concluded that Off-pump bypass surgical procedures are more advantageous than on-pump methods in COPD patients. These patients can be operated