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  • Title: Multiple arterial off-pump coronary artery bypass grafting: a 5-year experience with clinical results.
    Author: Biocina B, Sutlic Z, Rudez I, Baric D, Unic D, Stambuk B.
    Journal: Heart Surg Forum; 2003; 6(3):132-4. PubMed ID: 12821425.
    Abstract:
    BACKGROUND: The use of arterial grafts combined with the off-pump coronary artery bypass (OPCAB) procedure offers many advantages, but most of them are still to be proven in long-term studies. We present our 5-year experience in combining these 2 strategies in coronary surgery. METHODS: From February 1998 to December 2002 we operated on 155 patients (146 men and 9 women) for multiple arterial graft myocardial revascularization. All procedures were performed as OPCAB grafting using internal mammary and radial arteries. The mean +/- SD was 58 +/- 9 years for patient age, 57% +/- 11% for left ventricle ejection fraction, and 2.3 +/- 1.9 for the EuroSCORE. We reviewed perioperative and postoperative data and in-hospital mortality in our patients. RESULTS: A total of 356 distal anastomoses were created, an average of 2.3 per patient. The left internal mammary artery was used as a graft in 153 patients (98%), the right internal mammary artery was used in 13 patients (8%), and the radial artery was used in 146 patients (94%). No venous grafts were used. There were 4 reopenings (2.6%) because of mediastinal bleeding. Four patients (2.6%) experienced perioperative myocardial infarction, and 2 patients (1.3%) had permanent neurologic dysfunction. Five patients (3.2%) died in the hospital within 30 days of the operation. CONCLUSION: Our experience shows that arterial myocardial revascularization can be safely performed as an OPCAB procedure, even in the treatment of multiple-vessel coronary disease. The long-term benefit for patients is to be evaluated in the future.
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