Related Experiment Videos
[Coronary artery bypass grafting surgery without cardiopulmonary bypass]
1Department of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan.
Insights
On-pump coronary artery bypass grafting (CABG) surgery on a beating heart eliminates extracorporeal circulation. This technique showed an 89% graft patency rate with no deaths in 15 patients.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
- Surgical Innovation
Context:
- Traditional coronary artery bypass grafting (CABG) involves cardiopulmonary bypass and cardiac arrest.
- Advancements in surgical techniques now permit CABG on a beating heart, avoiding these effects.
- This study evaluates a specific technique for off-pump CABG.
Purpose:
- To assess the feasibility and outcomes of coronary artery bypass grafting (CABG) performed without cardiopulmonary bypass and cardiac arrest.
- To evaluate graft patency and perioperative safety in patients undergoing off-pump CABG.
- To determine the applicability of this technique in complex cases, including those with renal failure or poor left ventricular function.
Summary:
- Fifteen patients (age 47-82) underwent off-pump CABG between January 1991 and June 1992.
- The procedure involved 1-2 distal anastomoses to the LAD and/or RCA, utilizing the internal thoracic artery (ITA).
- Combined procedures were performed in 5 patients; no deaths or perioperative myocardial infarctions occurred, with a postoperative graft patency rate of 89% in 12 patients.
Impact:
- Demonstrates the safety and efficacy of off-pump CABG, particularly in high-risk patients.
- Highlights the potential to reduce complications associated with cardiopulmonary bypass.
- Offers a viable alternative surgical approach for coronary revascularization with favorable short-term outcomes.
Abstract:
Improved technique in coronary artery surgery has allowed coronary artery bypass graftings (CABG) to be placed on beating heart. The effects of extracorporeal circulation and cardiac arrest are eliminated. From Jan. 1991 to June, 1992, we performed CABG surgery without cardiopulmonary bypass and cardiac arrest in 15 patients; the age ranged from 47 to 82 years with the mean of 65. Patients who had LAD and/or RCA stenosis were candidate of this procedure in early series. However in recent series, we extended the candidate to three-vessel or LMT stenosis cases who were considered ineligible for standard CABG because of renal failure or poor left ventricular function. Distal anastomoses were performed with interruption of coronary flow. From one to two distal anastomosis to the LAD and/or RCA (mean 1.4/patient) were performed. The ITA was used in all 15 patients. Combined cardiac or vascular operation was performed in 5 patients (AAA repair, TAA repair, carotid endarterectomy or coronary endarterectomy). There were no deaths and no perioperative myocardial infarction. Postoperative angiography were performed in 12 patients with a patency rate of 89%.