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Direct myocardial revascularization without cardiopulmonary bypass.
The Thoracic and Cardiovascular Surgeon
|February 1, 1985
Summary
This study shows that coronary artery bypass grafting without cardiopulmonary bypass is safe and effective. This technique avoids extracorporeal circulation, reduces costs, and offers efficient anastomoses for myocardial revascularization.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) traditionally involves cardiopulmonary bypass (CPB).
- Off-pump coronary artery bypass (OPCAB) surgery offers an alternative to minimize CPB-related complications.
Purpose of the Study:
- To evaluate the safety and efficacy of coronary artery saphenous vein bypass revascularization performed without cardiopulmonary bypass.
- To assess the outcomes and advantages of the off-pump technique.
Main Methods:
- Retrospective analysis of 160 patients undergoing off-pump CABG using saphenous vein grafts.
- Distal anastomoses performed with temporary coronary artery flow interruption; proximal anastomoses with tangential aortic clamping.
- Vessels commonly revascularized: anterior descending and distal right coronary artery.
Main Results:
- The technique was applicable in 26.8% of eligible patients (160/597).
- Hospital mortality was 3.1% (5/160); perioperative myocardial infarction occurred in 2.5% (4/160).
- Graft patency rate was 83.9% in 62 restudied grafts; 41 patients (25.6%) underwent hemodynamic assessment.
Conclusions:
- Direct myocardial revascularization without cardiopulmonary bypass is safe and feasible.
- The off-pump technique offers efficient anastomoses, avoids extracorporeal circulation and blood transfusion, and reduces costs due to shorter hospital stays.