Related Experiment Videos
Off-pump multivessel coronary bypass via sternotomy is safe and effective
J D Puskas1, C E Wright, R S Ronson
1Carlyle Fraser Heart Center, Crawford Long Hospital of Emory University, Atlanta, Georgia 30365, USA. jpuskas@emory.edu
The Annals of Thoracic Surgery
|October 13, 1998
Summary
Off-pump coronary artery bypass grafting offers a safe and effective alternative to traditional bypass, reducing hospital stays, costs, and transfusions with excellent graft patency. This technique shows minimal morbidity and mortality in patients with coronary stenoses.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Procedures
- Cardiac Surgery Outcomes
Background:
- Off-pump coronary artery bypass grafting (OPCABG) is a refined technique to mitigate complications associated with cardiopulmonary bypass (CPB).
- This study aimed to evaluate OPCABG against traditional CPB in terms of clinical outcomes, length of stay, and hospital costs.
Purpose of the Study:
- To compare the clinical outcomes of off-pump coronary artery bypass grafting (OPCABG) versus traditional coronary artery bypass grafting (CABG) on cardiopulmonary bypass (CPB).
- To assess differences in length of stay and hospital costs between OPCABG and on-pump CABG.
Main Methods:
- Coronary artery bypass was performed on 51 patients using the off-pump technique.
- Patient selection was based on coronary anatomy, targeting stenoses in major coronary territories.
- Outcomes were compared to a matched control group (n=248) who underwent on-pump CABG during the same period.
Main Results:
- The off-pump group experienced no deaths, compared to a 1.6% mortality in the on-pump group.
- No stroke, myocardial infarction, or re-bleeding occurred in the off-pump cohort.
- Off-pump surgery resulted in a 3-day shorter hospital stay, 50% reduction in blood transfusions, and one-third lower hospital charges.
Conclusions:
- Off-pump multivessel coronary artery bypass grafting is a safe and effective revascularization strategy.
- The technique demonstrates excellent short-term graft patency, particularly for internal mammary artery grafts.
- OPCABG is associated with minimal morbidity and offers significant advantages in patient recovery and resource utilization.