Beating heart coronary artery bypass grafting: technical aspects and results in 200 patients.
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.
Dagenais
F
F
Montreal Heart Institute, Montreal, Canada.
Perrault
L P
LP
Cartier
R
R
Searle
N
N
Pagé
P
P
Pellerin
M
M
Pelletier
L C
LC
Carrier
M
M
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