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Related Experiment Videos

Multiple off-pump coronary revascularization with "aorta no-touch " technique using composite and sequential methods.

Junjiro Kobayashi1, Yoshikado Sasako, Ko Bando

  • 1Department of Cardiovascular Surgery, National Cardiovascular Center, Suita, Osaka, Japan. jkobayas@hsp.ncvc.go.jp

The Heart Surgery Forum
|July 13, 2002
PubMed
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The aorta no-touch technique for off-pump coronary artery bypass grafting (OPCAB) eliminates stroke risk by avoiding aortic clamping. This innovative method demonstrates excellent early clinical results and superior graft patency rates.

Area of Science:

  • Cardiovascular Surgery
  • Minimally Invasive Cardiac Surgery
  • Vascular Grafting

Background:

  • Off-pump coronary artery bypass grafting (OPCAB) is preferred for high-risk patients but carries stroke risk due to aortic clamping.
  • The "aorta no-touch" technique aims to mitigate this risk by eliminating the need for aortic manipulation.

Purpose of the Study:

  • To report the initial clinical outcomes of the "aorta no-touch" OPCAB technique.
  • To evaluate the efficacy of in-situ, composite, and sequential grafting methods within this technique.

Main Methods:

  • 120 patients underwent OPCAB using the "aorta no-touch" technique between March 2000 and April 2001.
  • Utilized internal thoracic arteries (ITAs), gastroepiploic arteries (GEA), and radial arteries (RA) for in-situ, composite (Y, I, K), and sequential grafts.

Related Experiment Videos

  • Arterial grafts constituted 92% of all bypass grafts, targeting major coronary arteries like LAD, posterolateral, and posterior descending branches.

    • Main Results:

    • No operative deaths or strokes were recorded.
    • Early postoperative angiography showed 95.5% overall graft patency.
    • Internal thoracic artery (ITA) to left anterior descending artery (LAD) grafts achieved 100% patency. ITA and radial artery (RA) patency (98.5%, 95.9%) significantly outperformed GEA (79.0%) and saphenous vein (82.3%) grafts.

    Conclusions:

    • The "aorta no-touch" OPCAB technique, incorporating in-situ, composite, and sequential grafting, yields excellent early clinical results.
    • This approach significantly improves graft patency, particularly with arterial conduits like ITAs and RAs.
    • It offers a safe and effective alternative for high-risk patients undergoing coronary artery bypass surgery.