Surgical myocardial revascularization without extracorporeal circulation

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery
• Minimally Invasive Cardiac Surgery

Background:

• Ischemic heart disease remains a leading cause of mortality worldwide.
• Traditional myocardial revascularization often involves extracorporeal circulation (ECC).
• Off-pump coronary artery bypass (OPCAB) surgery offers an alternative to ECC, potentially reducing complications.

Purpose of the Study:

• To evaluate the immediate postoperative outcomes of patients undergoing myocardial revascularization without extracorporeal circulation (off-pump coronary artery bypass - OPCAB).
• To assess the efficacy and safety of different graft types used in OPCAB surgery.
• To identify potential complications and management strategies in the early postoperative period.

Main Methods:

• A prospective study involving 112 patients undergoing OPCAB surgery.
• Patients were selected based on specific criteria including coronary artery caliber, lack of intramyocardial trajectory, noncalcified arteries, and tolerance to maneuvers.
• Postoperative monitoring included clinical observation and coronary angiography on the seventh postoperative day.

Main Results:

• OPCAB was successfully performed in 112 patients, with 3 requiring conversion to ECC (no impact on mortality).
• Common intraoperative events included arterial hypotension (89 patients), ventricular extrasystoles (58 patients), and atrial fibrillation (10 patients).
• Coronary angiography confirmed graft patency in all assessed patients on postoperative day 7.

Conclusions:

• Myocardial revascularization without extracorporeal circulation (OPCAB) is a reproducible and safe technique.
• OPCAB serves as a viable alternative for treating patients with ischemic heart disease.
• The study highlights the feasibility and positive graft outcomes associated with OPCAB surgery.