[Current status of off-pump coronary artery bypass grafting in 2003]

Accruing to the development of the apical suction device, the improvement of the suction type stabilizer, and the application of the trapezoidal pericardiotomy, we have performed off-pump coronary artery bypass (OPCAB) as the first choice procedure for coronary artery revascularization. In a recent series of coronary revascularization (100 cases), 99% of coronary artery bypass grafting was performed completely under OPCAB technique. The usage of the bilateral internal thoracic arteries under skeletonized technique with Harmonic Scalpel has become one of the standard procedures even in patients with diabetes mellitus, a high risk for cardiopulmonary bypass. There was no cerebrovascular accident, or mediastinitis in the postoperative course. In case of abdominal aortic aneurysm and arteriosclerosis obliterans with coronary artery disease, OPCAB combined with vascular surgery were performed simultaneously with an acceptable mortality rate (2.8%: 1/35). We believe that OPCAB can be the standard procedure for all patients with coronary artery disease.