MINI-off-pump coronary artery bypass graft: long-term results

In an effort to decrease the risks and costs associated with coronary artery bypass graft, in 1978 we repopularized off-pump coronary artery bypass graft (OPCABG) and expanded the technique, addressing lesions of the circumflex system and applying it to diverse clinical scenarios. In this article we describe our experience with 40 patients who received coronary revascularization through a MINI-OPCABG (Benetti technique) operation. Follow-up was achieved by direct communication with the patients or their family during 144 months. The interviews investigated survival, symptoms, long-term medical management and the need for reintervention. This group of patients had no operative mortality and 18 patients (45%) were extubated in the operating room. One patient (2.5%) experienced a perioperative myocardial infarction. During follow-up, two patients received percutaneous coronary intervention, one in the right coronary artery, the other in the circumflex system. A total of seven patients (17.5%) died. Overall, cumulative patient survival at 144 months was 82.5% (33 cases). Of the seven patients who died, four (10.0%) died of cardiac causes and 68.5% were free of symptoms. Technological advances will help to overcome the anatomical difficulties of this surgical technique, and when simplified, will allow it to be reproduced, offering patients a minimally invasive surgical alternative for the treatment of coronary disease, avoiding the limitations of percutaneous transluminal coronary angioplasty and coronary artery bypass graft.