title: A review of 1,582 consecutive Octopus off-pump coronary bypass patients.
abstract: BACKGROUND
  Off-pump coronary bypass may provide a safer form of surgical revascularization by avoiding the unwanted complications of cardiopulmonary bypass, particularly in the increasingly complex patients being referred for operation. This study reviews the entire experience of the Medtronic Octopus System (Medtronic, Minneapolis, MN) for beating heart bypass from 7 surgeons. Demographics, operative procedures, early outcomes, and trends in usage were examined.
  
  
  METHODS
  Patients were selected for off-pump procedures by the individual surgeons. Data were entered prospectively into locally maintained databases and then collected for collation and analysis.
  
  
  RESULTS
  A total of 1,582 consecutive Octopus patients were entered, representing the entire Octopus experience of each surgeon. Proportions of off-pump procedures relative to standard bypass increased over time, as did the percentage of patients receiving three or more grafts, 24.6% in 1997 and 55.9% in 1999. A total of 3,653 anastomoses were performed, 1,905 to the left anterior descending system, 837 to the circumflex distribution, and 911 to the right coronary territory. Morbidity was low. Few patients required conversion to cardiopulmonary bypass (2.6%; 0.2% urgently). Permanent stroke occurred in 0.6% and myocardial infarction in 1.2%. Operative mortality was 1%.
  
  
  CONCLUSIONS
  Octopus off-pump bypass was demonstrated to be a safe procedure with widening applicability. With experience surgeons tend to apply the system to increasing proportions of their patients and are able to revascularize all coronary territories.
authors.affiliation: Pinnacle Health System, Harrisburg, Pennsylvania, USA. jchart51@earthlink.net
authors.forename: J C
authors.initials: JC
authors.lastname: Hart
authors.forename: T H
authors.initials: TH
authors.lastname: Spooner
authors.forename: J
authors.initials: J
authors.lastname: Pym
authors.forename: T F
authors.initials: TF
authors.lastname: Flavin
authors.forename: J R
authors.initials: JR
authors.lastname: Edgerton
authors.forename: M J
authors.initials: MJ
authors.lastname: Mack
authors.forename: E W
authors.initials: EW
authors.lastname: Jansen
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome