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Coronary surgery without cardiopulmonary bypass
G Sani1, M A Mariani, F Benetti
1Istituto di Chirurgia Toracica e Cardiovascolare, Università degli Studi, Siena.
Cardiologia (Rome, Italy)
|November 1, 1995
Summary
Coronary artery bypass grafting without cardiopulmonary bypass (CPB) is a promising technique. This "beating heart" surgery offers a safe alternative to traditional methods with low complication rates.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Cardiopulmonary bypass (CPB) carries inherent risks in coronary artery bypass grafting (CABG).
- Interest in off-pump CABG (OPCAB) has grown to mitigate these risks.
Purpose of the Study:
- To evaluate the safety and efficacy of coronary artery bypass grafting without CPB.
- To assess the feasibility of OPCAB as an alternative to percutaneous coronary intervention and conventional CABG.
Main Methods:
- A prospective study of 58 patients undergoing OPCAB between November 1994 and May 1995.
- Procedures included median sternotomy or anterior thoracotomy, with video-assisted harvesting of the left internal mammary artery in some cases.
- Various arterial and venous grafts were utilized, including left internal mammary artery, saphenous vein, and radial artery.
Main Results:
- Low mortality rate (1.7%) and low incidence of postoperative low cardiac output syndrome (1.7%).
- Perioperative myocardial infarction occurred in 5.8% of patients.
- Absence of non-cardiac complications and arrhythmias, with short intensive care unit and hospital stays.
Conclusions:
- "Beating heart" coronary surgery (OPCAB) is a safe and promising alternative.
- OPCAB can be considered complementary to conventional CABG and an alternative to percutaneous transluminal coronary angioplasty.