[Routine application of trans-sternal off-pump coronary artery bypass grafting using innovative technique]

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Surgery
• Coronary Artery Disease Management

Context:

• Off-pump coronary artery bypass grafting (OPCAB) offers an alternative to traditional cardiopulmonary bypass.
• Managing complex multivessel coronary artery disease often requires innovative surgical approaches.
• The sternotomy approach for OPCAB has been extended to a broader patient population.

Purpose:

• To assess the safety and efficacy of a novel trans-sternal off-pump coronary artery bypass grafting (OPCAB) technique.
• To evaluate the outcomes of OPCAB in 100 consecutive patients with multiple coronary vessel lesions.
• To determine the clinical effectiveness and graft patency rates of the described surgical method.

Summary:

• A series of 100 patients with multivessel coronary artery disease underwent trans-sternal OPCAB utilizing a specific technique involving pericardial traction, compression, and a custom coronary shunt.
• The study reported a total of 322 distal anastomoses performed, with a mean of 3.22 grafts per patient.
• Graft conduits included arterial (LITA, RITA, RA, GEA) and venous (SVG) grafts, achieving an overall patency rate of 99.1% (100% for arterial, 95.4% for venous).
• The postoperative course was uneventful, with no organ failures, operative deaths, or hospital deaths.

Impact:

• The described OPCAB technique is demonstrated to be both effective and safe for treating complex coronary artery disease.
• Excellent early clinical outcomes and high graft patency rates support the wider adoption of this OPCAB method.
• This study contributes to the evidence base for advanced surgical strategies in coronary artery bypass grafting.