Total arterial revascularization on beating heart: experience in 803 cases.
To avoid the deleterious effects of cardiopulmonary bypass, total arterial revascularization was performed on the beating heart, using an Octopus stabilizer, in this prospective study of 803 patients without selection bias. Single-vessel disease was present in 71 (9%) patients, double-vessel disease in 204 (25%), and triple-vessel disease in 528 (66%). An ejection fraction < 30% was found in 127 (16%) cases. Angiography was carried out before discharge in 204 (25%) patients. Grafts included left and right internal mammary arteries and the radial artery. There were 2,661 grafts placed with a mean of 3.31 grafts per patient (range, 1 to 6). Operative mortality was 0.5%. There was no postoperative stroke and few incidences of renal impairment, even in patients with chronic renal failure. Blood transfusion was not required in 558 (69%) patients. Mean hospital stay was 5.6 days. Overall angiographic patency was 98.6%. Total arterial revascularization on the beating heart was found to be safe, effective, and reproducible in almost all patients, with excellent short-term patency rates and minimal morbidity.
Singh
Sushil Kumar
SK
Department of Cardiology & Cardiothoracic Surgery, Batra Hospital & Medical Research Centre, M.B. Road, New Delhi 110 0062, India.
Mishra
Surya Kumar
SK
Kumar
Deepak
D
Yadave
Ram Deo
RD
Agarwal
Rajiv
R
Sinha
Subhash Kumar
SK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D006348:Cardiac Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D002315:Cardiopulmonary Bypass; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome; D014654:Vascular Patency