Off-pump coronary artery bypass surgery--initial experience in Gdansk: a brief review

Before the introduction of cardiopulmonary bypass (CPB), coronary artery bypass grafting (CABG) procedures were performed on a beating heart. In 1967, Kolessov first reported "off-pump" revascularization of the left anterior descending artery (LAD). This technique was later abandoned when the use of cardioplegia and the heart-lung machine allowed a motionless and bloodless operative field. This study reports our initial clinical experience in off-pump coronary bypass surgery performed at the Department of Cardiac Surgery of the Medical University of Gdansk, Poland.

This study enrolled all consecutive patients who were operated on at our institution without CPB between January 1998 and December 2001. Patients were selected for the off-pump procedure individually by the surgeon. Demographics, operative procedures, postoperative mortality, morbidity, and early outcomes were analyzed. The observation period included 30 postoperative days.

An average of 1.8 grafts per patient were completed. Conversion to CPB was required in 4.1% of patients. Complete revascularization was attained in 91% of the procedures. Surgical mortality was 1.3% and perioperative myocardial infarction was reported in 2.4%.

In selected patients, off-pump CABG may be used as a suitable and safe alternative to conventional on-pump coronary surgery and permits complete revascularization with comparable short-term results.