[Off-pump coronary surgery. Experience in 220 patients].

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Cardiac Procedures
• Vascular Surgery

Background:

• Coronary artery bypass graft (CABG) surgery without cardiopulmonary bypass (CPB), known as off-pump CABG, presents an alternative myocardial revascularization strategy.
• This technique aims to reduce the complications associated with CPB.

Purpose of the Study:

• To evaluate the early outcomes and long-term results (4-year follow-up) of off-pump coronary artery bypass graft surgery.
• To assess the safety and efficacy of this technique in a series of 220 patients.

Main Methods:

• A descriptive study of 220 patients undergoing off-pump coronary surgery between 2004 and 2008.
• Patient data, including demographics, comorbidities (hypertension, diabetes, dyslipidemia, smoking), and preoperative status (angina, prior MI, angioplasty, ejection fraction), were collected.
• Complications, 30-day mortality, and long-term outcomes (late mortality, myocardial infarction, stroke, re-intervention) were assessed.

Main Results:

• A total of 481 bypasses were performed (average 2.27 per patient) with no incomplete revascularization and only 1.8% conversion rate.
• Postoperative complications occurred in 42 patients, including neurological, renal, cardiovascular, surgical, and infectious events.
• 30-day mortality was 1.36%. After a mean follow-up of 4.26 years, overall survival was 92.3%, with high rates of freedom from myocardial infarction (96.8%), stroke (96.8%), and re-intervention (95.9%).

Conclusions:

• Off-pump coronary artery bypass graft surgery demonstrates favorable early and late results in selected patient populations.
• The outcomes are comparable to traditional on-pump surgery, suggesting its viability as an alternative revascularization strategy.