title: Off-pump surgery: a choice in unstable angina.
abstract: The benefit and safety of off-pump coronary artery bypass surgery in patients with unstable angina was assessed retrospectively. From February 1996 to October 2001, 5,306 patients underwent multivessel off-pump coronary artery bypass, of whom 920 (17%) had unstable angina. In these 920 patients, ejection fractions ranged from 15% to 70%, 203 (22%) had an ejection fraction of 20%-35%, and 11 (1%) had an ejection fraction < 20%. Triple-vessel disease was present in 625 patients. Preoperative intraaortic balloon pump support was used in 28 patients. Operative approaches included mid sternotomy (86%), lower partial sternotomy (9%), and left anterior thoracotomy (2%). The number of grafts ranged from 1 to 5 with a mean of 2.43 +/- 0.86, and 92.3% of patients received a left internal mammary artery graft. Twenty-two patients need intraoperative intraaortic balloon pumping. Ten patients (1%) suffered perioperative myocardial infarction. The mean hospital stay was 7.8 +/- 4.3 days. Hospital mortality was 2/920 (0.22%). Intraaortic balloon pumping was helpful in these cases of unstable angina refractory to medical therapy. Off-pump coronary artery surgery was found to be safe and beneficial in these patients.
authors.affiliation: Escorts Heart Institute and Research Centre, Okhla Road, New Delhi 110-025, India. vijay_K22@yahoo.com
authors.forename: Vijay
authors.initials: V
authors.lastname: Kohli
authors.forename: Mukesh
authors.initials: M
authors.lastname: Goel
authors.forename: Vijay Kumar
authors.initials: VK
authors.lastname: Sharma
authors.forename: Yugal
authors.initials: Y
authors.lastname: Mishra
authors.forename: Rajneesh
authors.initials: R
authors.lastname: Malhotra
authors.forename: Yatin
authors.initials: Y
authors.lastname: Mehta
authors.forename: Naresh
authors.initials: N
authors.lastname: Trehan
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000503:physiopathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome