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[Off pump coronary artery bypass grafting in 51 cases]
1Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032, China.
Insights
Minimal invasive coronary bypass surgery, using an off-pump technique, offers a safe and cost-effective alternative. This approach reduces complications and improves recovery for patients, including those with high-risk factors.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Cardiac Anesthesia
Context:
- Coronary artery disease management
- Limitations of traditional cardiopulmonary bypass
- Need for reduced surgical morbidity
Purpose:
- Evaluate the safety and cost-effectiveness of minimal invasive coronary bypass surgery
- Assess outcomes in patients undergoing off-pump coronary artery bypass grafting
- Determine the suitability for high-risk patients and multivessel disease
Summary:
- Fifty-one patients underwent off-pump minimal invasive coronary bypass surgery via medial sternotomy.
- Low operative mortality (1.9%), short ICU (1.2 days) and hospital stays (6 days).
- High anastomosis patency (100%) and symptom-free angina in short-term follow-up.
Impact:
- Minimal invasive coronary bypass surgery is a safe and cost-effective option.
- Reduced complications and improved recovery compared to traditional methods.
- Viable for high-risk patients and those with multivessel coronary artery disease.
Objective:
To study the cost-effective minimal invasive coronary bypass surgery which decreases the complication associated with cardiopulmonary bypass, alleviates postoperative pain, and promotes recovery.
Methods:
From August 1998 to November 1999, fifty-one patients underwent minimal invasive coronary bypass surgery with off pump technique. Age range was from 39 to 80 years (average 64). Thirty-five patients suffered from myocardial infarction and nine patients diabetes. Left ventricular ejection fraction was from 20%-72% (average 53%). All procedures were completed through medial sternotomy. Stabilizers of CTS, Octopus, and USSC were applied. The average graft was 2.7 per case.
Results:
The operative mortality was 1.9%. The average ICU and hospital stay were 1.2 and 6 days, respectively. The average chest drainage and blood transfusion were 415 ml and 160 ml, respectively. Fifty patients survived from surgery. All survived patients had no symptoms of angina during the short-term follow-up (1 to 8 months). Two patients were followed up by postoperative coronary angiography, which showed a satisfactory anastomosis rate of 100%.
Conclusions:
Minimal invasive coronary bypass surgery is safe, cost-effective, and suitable for patients with high risk of extracorporeal circulation. It can also be used for multivessel disease.