Related Experiment Videos
Off-pump redo coronary artery bypass grafting
N Trehan1, Y K Mishra, R Malhotra
1Escorts Heart Institute and Research Centre, New Delhi, India.
The Annals of Thoracic Surgery
|October 4, 2000
Summary
Off-pump redo coronary artery bypass grafting in selected patients offers a safe alternative to conventional methods. This technique reduces morbidity and mortality, demonstrating satisfactory graft patency and shorter hospital stays.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Conventional redo coronary artery bypass grafting (CABG) carries significant risks, primarily due to sternal reopening and cardiac manipulation.
- Off-pump redo CABG, utilizing a patient-specific approach, presents an ideal alternative for selected individuals.
Purpose of the Study:
- To evaluate the safety and efficacy of off-pump redo coronary artery bypass grafting.
- To assess perioperative outcomes and graft patency in patients undergoing reoperative CABG without cardiopulmonary bypass.
Main Methods:
- Fifty patients underwent reoperative CABG without cardiopulmonary bypass between October 1995 and September 1999.
- Surgical approaches included left anterior minithoracotomy, midsternotomy, and posterolateral thoracotomy.
- Specific techniques involved left internal mammary artery (LIMA) to left anterior descending artery (LAD) anastomosis and grafting to other coronary targets.
Main Results:
- The study reported a 4% mortality rate (2 deaths) and low perioperative morbidity.
- No patients required reexploration for hemorrhage, and 38 patients avoided homologous blood transfusions.
- Check angiograms revealed all 16 assessed redo grafts were patent, with short recovery room and hospital stays.
Conclusions:
- Off-pump redo CABG is a viable option for selected patients, associated with low perioperative morbidity and mortality.
- The technique demonstrates satisfactory graft patency, supporting its use in reoperative cardiac surgery.