Off-pump myocardial revascularization using arterial conduits without cardiopulmonary bypass.
OBJECTIVE
The feasibility of myocardial revascularization via a median sternotomy with arterial conduits, without and with cardiopulmonary bypass (CPB), was evaluated.


RESULTS
From May 21, 1997, to November 30, 1999, 721 patients had myocardial revascularization without CPB via median sternotomy using at least two arterial conduits. The procedure was performed without CPB in 322 patients (Group A); the remaining 399 patients (Group B) underwent the same operation with the aid of CPB. Group A patients were older, with a higher ejection fraction and less redo than Group B. There was no early death in Group A versus nine (2.3%) patients in Group B (p < 0.02). Incidence of cerebrovascular accident (CVA) and acute myocardial infarction (AMI) were similar in both groups. Early major events incidences were 1.2% versus 8.0% (p < 0.001) in Groups A and B, respectively. Postoperative angiographic controls showed a cumulative patency rate of 98.4% and a perfect patency rate of 96.7%. After 30 months, Groups A and B showed an actuarial survival of 98.1 +/- 0.7 and 96.5 +/- 2.8 (p = ns) and an event-free survival of 96.6 +/- 1.0 and 96.5 +/- 2.8 (p = ns), respectively.


CONCLUSIONS
Myocardial revascularization without CPB using arterial conduits can be accomplished with the same quality of results obtained with the use of CPB.
Contini
M
M
Division of Cardiac Surgery, University G. D'Annunzio of Chieti, Italy.
Di Mauro
M
M
Vitolla
G
G
Mazzei
V
V
Iacò
A L
AL
Cirmeni
S
S
Di Giammarco
G
G
Calafiore
A M
AM
D000206:Actuarial Analysis; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D013249:Sternum / Q000601:surgery