Multivessel off-pump coronary artery bypass grafting can be taught to trainee surgeons.
BACKGROUND
Although Off-Pump Coronary Artery Bypass (OPCAB) surgery is being increasingly explored and practised in many cardiac units worldwide, there have been only few reports documenting the training of surgeons in this new technique. The purpose of this study was to address the reproducibility of the OPCAB in a unit where this technique is used extensively.


METHODS
Registry data, notes, and charts of 64 patients who were operated on by four trainee cardiac surgeons over a period of thirteen months at Harefield Hospital, were reviewed retrospectively. These trainees were part of an accredited training program for cardiothoracic training and were trained by a single consultant trainer in a cardiac unit after it had an established recent experience in performing nonselective OPCAB for all in-coming patients. Five (7.8%) patients (with 17 distal anastomoses) consented and underwent early postoperative angiography to check the quality of the grafts and anastomoses.


RESULTS
The mean age of the study patients was 65.6 and the mean Parsonnet score was 9.4. There was a mean of 2.9 grafts per patient and circumflex territory anastomoses were performed in 48 (75%) patients. No operation required conversion to Cardiopulmonary Bypass (CPB). Angiography of the five patients revealed 17 satisfactory (100%) distal anastomoses.


CONCLUSIONS
With appropriate training, it is possible for trainees to learn OPCAB and perform multivessel revascularization in relatively high-risk patients with good results.
Jenkins
David
D
The National Heart and Lung Institute, Imperial College of Science, Technology and Medicine, Harefield Hospital, Middlesex UB9 6JH, UK.
Al-Ruzzeh
Sharif
S
Khan
Shahid
S
Bustami
Mahmoud
M
Modine
Thomas
T
Yacoub
Magdi
M
Ilsley
Charles
C
Amrani
Mohamed
M
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D008875:Middle Aged; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery; D013903:Thoracic Surgery / Q000193:education*; D013908:Thoracotomy / Q000379:methods; D006113:United Kingdom