Coronary artery bypass surgery on the beating heart.
Authors report their experiences with coronary artery bypass surgery without cardiopulmonary bypass. Between January 1993 and June 1995, 151 patients were operated upon by the same surgeon for ischaemic heart disease (IHD); 7 were of them without extracorporeal circulation (ECC). Patients were selected for the procedure on the following criteria: (1) symptomatic patient with proximally occluded, anteriorly located, major subepicardial artery(ies) unsuitable for, or after failed, PTCA; (2) presence of associated disease (like hypertension, diabetes mellitus, chronic obstructive pulmonary disease) enhancing a possible deleterious effect of cardiopulmonary bypass; (3) favourable response to beta-blocking agent pretreatment without side effects. Seven patients' perioperative data (white cell count, platelet count, whole plasma protein level, chest drainage, CK-MB release--incidence of perioperative myocardial mess loss--and days spent in the intensive care unit /ICU/) are compared to the corresponding data of patients with comparable pathology operated on with ECC. No blood transfusion was required, nor perioperative myocardial necrosis occurred. The patients operated on without ECC spent only 24 hours in the ICU, and the clinical check-up after 1-24 months revealed conditions free from angina pectoris. The patient's quality of life improved.
Tarr
F
F
Department of Cardiovascular Surgery, Haynal Imre University of Health Sciences, Budapest, Hungary.
Somogyi
A
A
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome