[Left main coronary artery stenosis and revascularization in the beating heart. Short- and long-term experience].
OBJECTIVE
To determine the safety of surgical revascularization without cardiopulmonary bypass in left main coronary artery stenosis.


METHODS
Between October 1996 and October 1998, 67 patients with a left main stem stenosis (LMS) (> 50%) underwent revascularization on beating heart surgery (BHS) and were compared to a cohort of 192 patients with LMS disease that were operated on under cardiopulmonary bypass (CPB) during 1996.


RESULTS
Mean age and sex distribution and prevalence of preoperative risk factors were the same in both groups as well as the average number of grafts per patient was 3.1 +/- 0.7 and 2.9 +/- 0.7 in BHS and CPB groups respectively. Perioperative infarction rate (defined arbitrarily as a CK-MB > 100 IUL) was 2.9% in BHS group and 3.1% in CPB group. Postoperative blood transfusion requirements were less in BHS group (38%) compared to CPB group (64%), p < 0.05. Inotropic requirements postoperatively were similar in both groups. Hospital stay was shorter in BHS group (6.8 days) compared to CPB group (7.6 days) although not significant. There was no operative mortality in BHS group whereas 4.7% died postoperatively in CPB group.


CONCLUSIONS
Our experience suggests that non-bypass surgical revascularization is a feasible and safe alternative to conventional cardiopulmonary bypass.
Cartier
R
R
Département de Chirurgie Cardiaque (chirurgien cardiovasculaire), Institut de Cardiologie de Montréal, Québec, Canada.
Brann
S
S
Martineau
R
R
Couturier
A
A
D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000401:mortality; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003250:Constriction; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D018579:Patient Selection; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome
D002316:Cardiotonic Agents
Sténose coronarienne du tronc commun et revascularisation à coeur battant. Expérience à court et long terme.