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Direct myocardial revascularization without extracorporeal circulation: technique and initial results
E Buffolo1, J C Andrade, J E Succi
1Department of Surgery, Paulista School of Medicine, São Paulo, Brazil.
Texas Heart Institute Journal
|March 1, 1985
Summary
This study explored off-pump coronary artery bypass grafting using saphenous vein grafts. The technique demonstrated low mortality and acceptable graft patency, offering a viable surgical option.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Techniques
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
- Minimally invasive techniques aim to reduce surgical trauma and recovery time.
Purpose of the Study:
- To evaluate the feasibility and early outcomes of off-pump coronary artery bypass (OPCAB) grafting using saphenous vein grafts.
- To assess the safety and efficacy of a specific OPCAB technique involving interrupted distal coronary flow without perfusion devices.
Main Methods:
- A prospective study of 68 patients undergoing OPCAB surgery over 10 months.
- Distal anastomoses performed with coronary flow interruption; proximal anastomoses with aortic tangential clamping.
- Revascularization primarily targeted the anterior descending and distal right coronary arteries.
Main Results:
- The technique was applicable in 30.2% of eligible CABG patients (68 out of 225).
- Thirty-day hospital mortality was 1.5%.
- Perioperative myocardial infarction occurred in 2 patients; graft patency was 84.2% in restudied grafts.
Conclusions:
- Off-pump saphenous vein bypass grafting without perfusion devices is a feasible technique.
- This approach is associated with low early mortality and acceptable graft patency rates.
- Further studies are warranted to compare long-term outcomes with conventional CABG.