Triple coronary artery revascularization on the stabilized beating heart: initial experience.
OBJECTIVE
To decrease health costs and morbidity related to extracorporeal circulation, surgeons have modified the coronary artery bypass (CAB) technique so that it can be completed without the use of extracorporeal circulation. This study summarizes initial experience with direct coronary artery revascularization on the beating heart using a coronary stabilizer.


METHODS
A case series.


METHODS
The Montreal Heart Institute, a university-affiliated centre, specializing in the treatment of cardiac illnesses.


METHODS
Ten patients underwent CAB by this technique. They presented with double or triple coronary artery disease with no intramyocardial, heavily calcified, diffused atheromatous coronary vessels, or left main coronary disease.


METHODS
CAB grafting in the beating heart. The anterior wall was grafted in all patients, the inferior wall in 7 and the posterior wall in 7.


METHODS
Patient survival and graft patency.


RESULTS
One patient died of multiple organ failure not related to the grafting technique itself, and 1 patient suffered a non-Q myocardial infarction. Early coronary angiography performed on 8 patients showed 100% graft patency, most with excellent distal runoff (21/22 grafts).


CONCLUSIONS
In patients with adequate anatomy, performance of CAB without extracorporeal circulation can achieve excellent early results provided there is appropriate mechanical stabilization of the beating heart.
Department of Cardiovascular Surgery, Montreal Heart Institute, Que.
R
R
Cartier
Y
Y
Hébert
R
R
Blain
N
N
Tremblay
J
J
Desjardins
Y
Y
Leclerc
D000368:Aged; D000789:Angina, Unstable / Q000503:physiopathology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000379:methods*; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome