title: Conscious off-pump coronary artery bypass surgery.
abstract: BACKGROUND
  Cardiothoracic surgery has been previously performed successfully under thoracic epidural anesthesia alone. Between October 2001 and December 2003, we performed 123 conscious off-pump coronary artery bypass surgeries using epidural anesthesia as the sole anesthetic. This technique is an alternative to cardiothoracic surgery performed under general anesthesia. Certain modifications in the technique facilitate the process.
  
  
  RESULTS
  There were 24 female patients and 99 male patients with mean age of 58.6 +/- 6.2 years; 12 patients underwent repeat coronary artery bypass surgery. All the patients underwent epidural catheterization on the evening before surgery. Out of the 123 patients scheduled for coronary artery bypass graft surgery, 120 underwent off-pump coronary artery bypass graft surgery successfully; 4 patients underwent off-pump surgery via left thoracotomy and the rest through mid sternotomy. These patients received 295 grafts in all (single graft in 26 patients, double in 42 patients, triple in 35 patients, and quadruple in 20 patients). Three patients required conversion to general anesthesia and one to cardiopulmonary bypass. There was no mortality in the group.
  
  
  CONCLUSIONS
  Our experience suggests that by modifying the surgical techniques, we can accomplish conscious coronary artery bypass surgery.
authors.affiliation: Wockhardt Heart Institute, Bangalore. chakravarthy@vsnl.com
authors.forename: Murali
authors.initials: M
authors.lastname: Chakravarthy
authors.forename: Vivek
authors.initials: V
authors.lastname: Jawali
authors.forename: Murali
authors.initials: M
authors.lastname: Manohar
authors.forename: T A
authors.initials: TA
authors.lastname: Patil
authors.forename: K
authors.initials: K
authors.lastname: Jayaprakash
authors.forename: N V
authors.initials: NV
authors.lastname: Shivananda
authors.forename: Gilbert
authors.initials: G
authors.lastname: Joseph
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Kolar
authors.forename: Jayant Kumar
authors.initials: JK
authors.lastname: Das
mesh_terms: D000767:Anesthesia, Epidural; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged