Total arterial revascularization on beating heart: experience in 803 cases

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Interventional Cardiology

Background:

• Cardiopulmonary bypass can lead to adverse effects.
• Total arterial revascularization aims to mitigate these risks.
• Beating heart surgery offers an alternative approach.

Purpose of the Study:

• To evaluate the safety and efficacy of total arterial revascularization on the beating heart.
• To assess short-term outcomes, including graft patency and morbidity.
• To determine the reproducibility of the procedure in a large, unselected patient cohort.

Main Methods:

• Prospective study of 803 patients undergoing total arterial revascularization on a beating heart.
• Utilized an Octopus stabilizer for myocardial stabilization.
• Included various arterial grafts: internal mammary and radial arteries.
• Assessed outcomes including operative mortality, stroke, renal impairment, blood transfusion rates, hospital stay, and angiographic patency.

Main Results:

• Operative mortality was low at 0.5%.
• No postoperative strokes and minimal renal impairment were observed.
• 558 patients (69%) did not require blood transfusions.
• Mean hospital stay was 5.6 days.
• Overall angiographic graft patency was high at 98.6%.

Conclusions:

• Total arterial revascularization on the beating heart is a safe, effective, and reproducible technique.
• The procedure demonstrates excellent short-term graft patency and minimal patient morbidity.
• This approach is suitable for a wide range of patients, including those with complex coronary artery disease and reduced ejection fraction.