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J Thorac Cardiovasc Surg 2007;133:387-388
© 2007 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Discussion

Dr John D. Puskas (Atlanta, Ga). My congratulations to you and your colleagues from Hyderabad for enrolling 116 patients in 16 months in a randomized surgical trial. That may be a world record for a single center.

Your study has again demonstrated, as others have, that OPCAB is associated with a significant decrease in inotrope dependence, transfusion, chest tube drainage, and ventilation time. You have also found a trend toward a decrease in death and postoperative hemodialysis, but your primary end point was to focus on the increase in serum creatinine and decline in GFR after CPB, and you demonstrated a benefit for OPCAB that was greatest in diabetic patients and in hypertensive patients. I have several questions for you.

First, how well did you control the mean CPB perfusion pressures during the on-pump cases, and how did that compare . . . [Full Text of this Article]