title: Active perfusion of coronary grafts facilitates complex off-pump coronary artery bypass surgery.
abstract: BACKGROUND
  Hemodynamic stability during cardiac manipulation for complex, multivessel off-pump coronary artery bypass grafting (OPCAB) remains problematic.
  
  
  METHODS
  A servo-controlled pump has been utilized to deliver warm whole blood to coronary grafts prior to construction of proximal anastomoses.
  
  
  RESULTS
  This technique may avoid detrimental hemodynamic decompensation, which may accompany regional coronary ischemia during cardiac displacement. It may also allow precise infusion of supplemental additives leading to coronary vasodilatation, myocardial resuscitation, and enhancement of myocardial contractility.
  
  
  CONCLUSIONS
  In this report, three complex OPCAB cases are described which were successfully performed with active graft perfusion and which might not otherwise have been technically feasible by conventional OPCAB techniques.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, The Carlyle Fraser Heart Center, Crawford Long Hospital of Emory University, Atlanta, GA 30365, USA. jpuskas@emory.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Puskas
authors.forename: V H
authors.initials: VH
authors.lastname: Thourani
authors.forename: J
authors.initials: J
authors.lastname: Vinten-Johansen
authors.forename: R A
authors.initials: RA
authors.lastname: Guyton
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000379:methods*; D003326:Coronary Circulation; D006353:Heart-Assist Devices; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D012086:Reoperation