[Non-compromised grafting policy in off-pump coronary artery bypass].
BACKGROUND
The off-pump coronary artery bypass (OPCAB) has been prevalent around the world. However the most optimal selection of graft conduits has still been controversial.


METHODS
Between January 2002 and April 2003, 126 consecutive isolated coronary artery bypass procedures were attempted to performed without cardiopulmonary bypass. A mean age of the patients was 69.3 (47-90). Fifteen patients were operated on emergently and 16 were urgently, including 15 patients requiring preoperative intra-aortic balloon pumping (IABP). Five patients underwent reoperative coronary bypass.


RESULTS
All procedures were completed without cardiopulmonary bypass. The mean number of grafts per patient was 3.23 (range, 1 to 6). The skeletonized arterial conduits were aggressively used [117 left internal mammary artery (LIMA) to 155 sites, 70 right internal mammary artery (RIMA) to 79 sites, 57 right gastro-epiploic artery (RGEA) to 82 sites and 49 saphenous vein (SV) to 91 sites]. Cardiac-related hospital mortality was none. Angiographic assessment of grafts demonstrated that patency of LIMA, RIMA, RGEA and SV were 98.6%, 100%, 100%, and 97.6% respectively.


CONCLUSIONS
OPCAB with skeletonized in situ arterial conduits is secure and feasible.
Asai
T
T
Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
Shiraishi
S
S
Higashita
R
R
Matsubayashi
K
K
Nishi
T
T
Kambara
A
A
Koike
M
M
D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D004630:Emergencies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency