title: Beating heart coronary artery bypass grafting: technical aspects and results in 200 patients.
abstract: OBJECTIVE
  To describe the initial experience of the first 200 patients who underwent coronary artery bypass grafting (CABG) on beating hearts at the Montreal Heart Institute, Montreal.
  
  
  METHODS
  A prospective cohort of 200 patients was analyzed to study immediate and short term (two-year follow-up) results.
  
  
  METHODS
  Patients underwent CABG at the Montreal Heart Institute from February 1996 to June 1998. The first 30 patients underwent CABG without the use of a myocardial wall stabilizer (group 1), and a myocardial wall stabilizer was used in the following 170 patients (group 2).
  
  
  METHODS
  Group 1 patients averaged 60+/-10 years of age compared with 66+/-10 years in group 2 (P=0.002). Twelve patients (40%) in group 1 had unstable angina compared with 107 patients (63%) in group 2 (P=0.03).
  
  
  METHODS
  Group 1 patients underwent 1.7+/-0.7 CABG per patient compared with 2.4+/-0.8 grafts per patient in group 2 (P=0.001). Sixty-seven patients (39%) in group 2 had an obtuse marginal coronary artery grafted, and 145 patients (73%) of both groups had a complete myocardial revascularization.
  
  
  RESULTS
  Ten patients (5%) in both groups were converted to cardiopulmonary bypass during surgery. Seven patients (3.5%) died postoperatively: five from myocardial infarction, one from aortic dissection and rupture, and one from arrhythmia. Seventeen patients (8.5%) suffered a perioperative myocardial infarction. In groups 1 and 2, respectively, actuarial survival was 100% and 95+/-2%, and freedom rate from reoperation, percutaneous balloon dilation and recurrent myocardial infarction averaged 93+/-4% and 97+/-2% 18 months following CABG.
  
  
  CONCLUSIONS
  CABG on beating hearts appears to be an alternative approach to the use of cardiopulmonary bypass in selected patients.
authors.affiliation: Montreal Heart Institute, Montreal, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Dagenais
authors.forename: L P
authors.initials: LP
authors.lastname: Perrault
authors.forename: R
authors.initials: R
authors.lastname: Cartier
authors.forename: N
authors.initials: N
authors.lastname: Searle
authors.forename: P
authors.initials: P
authors.lastname: Pagé
authors.forename: M
authors.initials: M
authors.lastname: Pellerin
authors.forename: L C
authors.initials: LC
authors.lastname: Pelletier
authors.forename: M
authors.initials: M
authors.lastname: Carrier
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000401:mortality / Q000601:surgery; D002315:Cardiopulmonary Bypass; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000295:instrumentation*; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality; D012307:Risk Factors; D013525:Surgical Instruments; D016019:Survival Analysis