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Ann Thorac Surg 1997;63:606-607
© 1997 The Society of Thoracic Surgeons
Division of Cardiac Surgery, Department of Surgery, Baystate Medical Center, Springfield, Massachusetts
| The first 20% of the full text of this article appears below. |
See also page 634.
Ott and associates [1] have reviewed their experience in an expedited recovery protocol after coronary artery bypass grafting to determine its efficacy in an elderly population. They have clearly shown that early discharge is feasible in a substantial proportion of patients 70 years of age or older (19% discharged in <5 days after operation and 88% in <10 days). As emphasized by Ott and associates, a carefully defined protocol is required that is based on an uncomplicated operation and an anesthetic approach permitting early extubation.
The expedited recovery protocol by Ott and associates primarily employs the fast-track principles as described by both Krohn and associates [2] and Engelman and associates [3] with some significant modifications that deserve editorial comment. First and foremost is the decision to promote as a major goal of their approach a reduction of operative time with cardiopulmonary bypass limited to less than 75 minutes and ischemic time to less than 45 minutes. This, by necessity,
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