Off-pump total arterial revascularization: our experience.
OBJECTIVE
Off-pump coronary artery bypass grafting with both the internal thoracic arteries, such as the Tector technique, can reduce the morbidity associated with extracorporeal circulation and aortic cross-clamp. The aim of the present study is to describe our experience and the results obtained.


METHODS
From April 1998 to December 2003, the off-pump Tector technique was performed on 743 patients, of whom 621 were male (83.5%), with a mean age of 65.3 +/- 9.5 years (23-90). Preoperative risk factors were diabetes mellitus in 29.5% and peripheral vasculopathy in 14.7% of the patients. Angiography showed left main disease in 25.6% and triple-vessel disease in 50.3% of the patients, with a mean ejection fraction of 60%+/- 13% (23-88). Both the internal thoracic arteries were harvested using the skeletonization technique and were anastomosed as "Y" or "T" grafts. Intraoperative graft patency was checked using a Doppler flowmeter.


RESULTS
A total of 2028 distal anastomoses were performed, the average being 2.7 (1 to 5) per patient. At least three distal anastomoses were undertaken in 62% of the patients. Postoperative complications included atrial fibrillation in 40 patients (5.4%), myocardial infarction in 24 (3.2%), mediastinitis and reoperation for bleeding in 7 (0.9%) and stroke in 3 (0.4%). Twenty-four patients (3.2%) died in the first month postoperatively.


CONCLUSIONS
The off-pump Tector technique appears to be safe, showing a low surgical morbidity.
Tarrío
Rubén Fernández
RF
Cardiac Surgery Service, Juan Canalejo Hospital, A Coruña, Spain. rutarrio@yahoo.es
Cuenca
José Joaquin
JJ
Gomes
Valdemar
V
Campos
Vicente
V
Herrera
José Maria
JM
Rodríguez
Fernando
F
Valle
José Vicente
JV
Portela
Francisco
F
García-Carro
Javier
J
Adrio
Belén
B
Vázquez
Francisco
F
Juffé
Alberto
A
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome