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[Coronary revascularization on beating heart].

T Sugár1, E Nagy, A Somogyi

  • 1Szív- és Ersebészeti Klinika, Semmelweis Egyetem, Budapest.

Orvosi Hetilap
|November 7, 2000
PubMed
Summary
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Off-pump coronary artery bypass grafting (CABG) using normothermic techniques offers a less invasive approach. This method resulted in low mortality, reduced complications, and shorter intensive care unit stays.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Anesthesia

Context:

  • Coronary artery bypass grafting (CABG) is a common surgical procedure.
  • Minimally invasive techniques are increasingly preferred to reduce patient morbidity.
  • On-pump CABG (using cardiopulmonary bypass, ECC) has been the traditional standard.

Purpose:

  • To evaluate the outcomes of off-pump CABG (OPCAB) performed using normothermic techniques.
  • To assess the safety and efficacy of OPCAB compared to traditional on-pump CABG.
  • To determine if OPCAB compromises the completeness of revascularization.

Summary:

  • A total of 134 OPCAB procedures were performed by a single surgical team using normothermia.
  • 98 procedures were performed without extracorporeal circulation (ECC) support, and 36 with ECC support.

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  • The study reported a low postoperative mortality rate of 2.2%, minimal myocardial infarction (CK-MB release), reduced bleeding, and a mean ICU stay of 19 hours.
  • Arterial revascularization was achieved in 94% of patients, with an average of 2.7 bypasses per patient.
  • Conversion to cardiac arrest was not required in any case.

    • Impact:

    • OPCAB performed under normothermia is a less invasive surgical option for coronary revascularization.
    • This technique can decrease postoperative complications and shorten intensive care unit stays.
    • The principle of complete revascularization is maintained with this approach, even in patients with significant preoperative myocardial infarction.