Isolated myocardial revascularization with intermittent aortic cross-clamping: experience with 800 cases

Background. We investigated the clinical outcome of elective and nonelective myocardial revascularization performed with intermittent aortic cross-clamping. Methods. Prospective data on 800 consecutive patients (from May 1996 to July 2000), who underwent isolated myocardial revascularization with intermittent aortic cross-clamping, were analyzed. A subgroup analysis was performed on the elective (n = 520), urgent (n = 226), and emergency (n = 54) procedures. Results. The elective group of patients had a mean age of 61.5 ± 9.46 years, mean Parsonnet score of 5.23 ± 5.1, and mean number of distal anastomoses of 3.22 ± 1.04. The hospital mortality was 0.57%. The urgent group of patients had a mean age of 63.06 ± 10.43 years, mean Parsonnet score of 6.73 ± 6.22, and mean number of distal anastomoses of 3.21 ± 1.04. The hospital mortality was 3.09%. The emergency group of patients had a mean age of 63.75 ± 9.63 years, mean Parsonnet score of 11.24 ± 11, and mean number of distal anastomoses of 2.87 ± 0.86. Hospital mortality was 5.55%. Postoperative hospital stay was 7.11 ± 5.47 days for the elective group, 7.59 ± 5.07 days for the urgent group, and 7.40 ± 4.01 days for the emergency group. Conclusions. Intermittent aortic cross-clamping is a safe technique both in elective and nonelective patients. The mortality and morbidity in the three subgroups analyzed reflects patients’ distribution against Parsonnet score.