Background: Beating-heart surgery with warm blood perfusion, instead of cardioplegic solution, has been widely accredited to be a feasible technique in the cardiac operation. However, few studies have addressed the efficacy and safety of on-pump beating-heart surgery, especially with large numbers of patients. In this study, the efficacy and safety of on-pump beating-heart surgery was evaluated by surveying 701 patients with cardiac disease.
Methods: Preoperative risk factors, intraoperative techniques, and postoperative complications were documented and evaluated in 701 consecutive patients (from January 1, 2002, to December 30, 2006) who underwent beating-heart surgery with continuous antegrade or retrograde warm blood perfusion at The People's Hospital of Guangxi Zhuang Autonomous Region.
Results: Among the 701 patients with beating-heart surgery, antegrade perfusion was used in 556 patients (79.32%); retrograde perfusion was used in 40 patients (5.71%); and retrograde perfusion followed by antegrade perfusion was performed in 93 patients (13.27%). Cardioplegic arrest was required in 12 patients (1.71%) for inadequate visualization. In 4 of 701 patients (0.57%) low cardiac output syndrome occurred. Hemoglobinuria occurred in 16 patients (2.28%). No air embolization or permanent high-degree atrioventricular block occurred in these patients. The crude mortality of the surveyed patients was 2.43% (17 of 701).
Conclusions: Our results indicate that on-pump beating-heart surgery is a relatively safe and reliable technique for treatment of cardiac diseases.