[Multiple off pump coronary artery bypass grafting - risks and benefits]

Area of Science:

• Cardiac Surgery
• Minimally Invasive Procedures
• Vascular Surgery

Context:

• Off-Pump Coronary Artery Bypass Surgery (OP CAB) is increasingly important.
• New stabilization devices enable posterior wall and distal coronary artery revascularization.
• High-risk patients benefit from avoiding extracorporeal circulation's negative effects.

Purpose:

• To evaluate the effectiveness of OP CAB compared to conventional CABG.
• To assess perioperative complications, particularly neurologic deficits.
• To compare outcomes in high-risk patients undergoing beating heart surgery.

Summary:

• 158 patients underwent OP CAB, while 2869 had conventional CABG between 7/97 and 12/99.
• OP CAB group had no permanent neurologic deficits, versus 1.3% stroke rate in CABG group.
• Higher temporary neurologic deficits in OP CAB due to patient selection; no aortic dissection observed.

Impact:

• OP CAB demonstrates effectiveness in reducing perioperative complications and improving survival, especially for high-risk patients.
• Beating heart surgery avoids extracorporeal circulation, mitigating associated risks.
• Further long-term studies are needed to compare OP CAB outcomes with conventional on-bypass surgery.