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Updated: Oct 2, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
[Coronary artery bypass grafting without extracorporeal circulation]
E Kovács1, Z Szabolcs, T Gyöngy
1Semmelweis Egyetem Altalános Orvostudományi Kar, Er- és Szívsebészeti Klinika, 1122 Budapest, Városmajor utca 68.
Insights
Off-pump coronary artery bypass surgery (CABG) in 57 patients showed a 3.5% mortality rate. Most patients experienced improved condition and remained angina-free post-surgery.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Context:
- The study was conducted at Semmelweis University, Budapest, between 1996 and September 2001.
- Focus on coronary artery bypass operations performed without cardiopulmonary bypass (off-pump CABG).
- Initial cases involved 1-2 vessel diseases and anterior heart surface revascularization, with a learning phase utilizing manual and mechanical stabilization devices.
Purpose:
- To evaluate the outcomes and safety of off-pump coronary artery bypass surgery.
- To assess the feasibility of off-pump CABG in a specific patient cohort.
- To analyze complications, mortality, and long-term follow-up results.
Summary:
- 57 off-pump CABG operations were performed.
- The majority were elective procedures, with 2 REDO cases.
- 48 patients recovered without complications; mortality was 3.5% (2 deaths).
- Postoperative complications included 2 emergent PTCA and 3 perioperative infarctions.
- Follow-up (95% at 15 months) revealed significant cardiac events in 7 patients, with most experiencing improved condition and freedom from angina.
Impact:
- Off-pump CABG demonstrated a low mortality rate and a high rate of angina relief.
- The study highlights the potential benefits of off-pump techniques in selected patients.
- Findings contribute to the understanding of off-pump CABG safety and efficacy in improving patient quality of life.
Abstract:
At the Department of Cardiovascular Surgery of Semmelweis University, Budapest we have performed 57 coronary bypass operations without using cardiopulmonary bypass between 1996 and September 2001. Due to the learning phase we preferred cases of 1-2 wessel diseases, and revascularisation necessary on the anterior surface of the heart. In the beginning the stabilization of the operative field was ensured by manual methods, then by applying mechanical stabilization devices (Octopus 2, Genzyme). As to the type of operative indication overwhelmingly elective operations were performed. REDO procedure, i.e. repeated coronary bypass operation was carried out in 2 cases. Forty-eight patients recovered without complication. Two patients died, one of them suffered perioperative infarction, the other died due to cerebral complication. Total mortality was 3.5%. As a consequence of cardiac ischaemia in the direct postoperative period, we performed emergent coronary ballon dilatation (PTCA) in two cases. In three cases we experienced perioperative infarction. We followed up our patients by way of interview and telephone interview. The follow-up is 95%, the average follow-up time is 15 months. Significant cardiac event (infarction, PTCA or REDO coronary operation) took place in the case of 7 patients. In the majority of our patients the operation resulted in an improvement of condition, 43 patients are free from angina.
