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[Evaluation of cases of off-pump CABG with mid-sternotomy]
1First Department of Surgery, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Insights
Off-pump coronary artery bypass grafting (CABG) is effective for multivessel coronary artery disease, even with comorbidities. This study shows high complete revascularization rates and no hospital deaths in 79 patients.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Minimally Invasive Cardiac Surgery
Background:
- Off-pump coronary artery bypass grafting (OPCAB) is an alternative for patients with multivessel coronary artery disease (CAD) and comorbidities.
- Evaluating OPCAB outcomes in a complex patient cohort is crucial for surgical decision-making.
Purpose of the Study:
- To assess the safety and efficacy of off-pump CABG in patients with multivessel CAD and other organ diseases.
- To report revascularization success rates and early postoperative complications.
Main Methods:
- Retrospective evaluation of 79 patients undergoing off-pump CABG.
- Analysis of graft types used (LITA, RA, GEA, RITA, IEA, SVG) and target coronary arteries.
- Documentation of operative times, conversions to on-pump, and postoperative outcomes.
Main Results:
- Complete revascularization was achieved in 78 out of 79 patients (98.7%).
- Commonly used grafts included Left Internal Thoracic Artery (LITA) and Saphenous Vein Graft (SVG).
- Low rates of complications were observed, including one postoperative Cerebrovascular Accident (CVA) and two wound infections; no hospital deaths occurred.
Conclusions:
- Off-pump CABG is a safe and effective revascularization strategy for patients with multivessel CAD and comorbidities.
- High rates of complete revascularization and favorable early outcomes support the use of OPCAB in selected complex patients.
Abstract:
Off-pump CABG was utilized on patients who had multivessel coronary artery disease and other organ diseases. A total of 79 patients who underwent off-pump CABG were evaluated. Of these, 66 suffered from OMI and AP, 4 form AP, 6 from u-AP, and 3 from AMI. LITA was used in 75 cases, RA in 48, GEA in 45, RITA in 13, IEA in 3, and SVG in 38. Revascularization was performed at # 2 in 3 cases, # 3 in 11, 4 PD in 37, 4 PL in # 7 or # 8 in 79, # 9 in 27, # 12 in 51, and # 14 in 17. A time of 10.3 min was spent on LAD revascularization, 9.8 min on D 1, 10.2 min on Cx, anf 11.5 on RCA. Seven patients were transferred to on-pump beating CABG because of hemodynamic instability. One patients suffered postoperative CVA, and 2 had wound infection. Complete revasculization was accomplished in 78 patients, and hospital death was not reported.