Aortic nontouch off-pump complete revascularization using 3 in situ arterial conduits: bilateral internal mammary arteries and gastroepiploic artery.
BACKGROUND
Arterial grafts have been used frequently in recent coronary artery bypass grafting (CABG). Off-pump CABG can facilitate early patient recovery. A combination of in situ graft and off-pump technique results in complete aortic nontouch surgery; however, outcome has not been well established.


METHODS
Between May 1998 and December 2001, 1035 consecutive isolated CABG operations were performed at Juntendo-Shin-Tokyo Hospital Group. Of these, off-pump CABG using in situ bilateral internal mammary arteries and in situ gastroepiploic artery was performed in 48 patients (41 men and 7 women; mean age, 74.5 +/-9.9 years). Perioperative and follow-up data were studied.


RESULTS
The average number of distal anastomoses was 3.4 +/-0.7, and complete revascularization was achieved in all patients. There were no hospital deaths. Perioperative myocardial infarction was observed in 1 patient, congestive heart failure in 1, stroke in 2, and mediastinitis in 1. Postoperative catheterization was performed in 30 patients and revealed no graft occlusions. During the follow-up period of 2.3 +/- 1.2 years, no remote deaths, angina recurrence, or coronary interventions were observed.


CONCLUSIONS
Off-pump CABG using an all in situ arterial graft can be performed safely, and follow-up results are excellent.
Hirose
Hitoshi
H
Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan. genex@nifty.com
Amano
Atsushi
A
Takahashi
Akihito
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods / Q000401:mortality* / Q000706:statistics & numerical data*; D005260:Female; D024405:Gastroepiploic Artery / Q000637:transplantation*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome