title: Early angiographic results of multivessel off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  Recently off-pump coronary artery bypass grafting (CABG) is being widely used for coronary revascularization. However, there is some evidence that off-pump surgery increases the risk of recurrent angina and the need for reintervention, suggesting poor graft quality or incomplete revascularization. We describe our experience to demonstrate the feasibility of multiple coronary revascularization in off-pump CABG (OPCAB).
  
  
  METHODS
  From January 2002 to March 2003, 168 patients underwent OPCAB at our institute. In 16 of them, 6 to 9 vessels were revascularized in each patient. There were 14 males and 2 females with a mean age of 66 years (47 to 74 years). All patients had triple-vessel disease. Ten patients received in situ arterial grafts only which were harvested with the skeletonization technique using an ultrasonic scalpel. We used the Starfish heart positioner to expose lateral, posterior, and inferior walls of the heart with minimal hemodynamic compromise.
  
  
  RESULTS
  All patients were discharged from the hospital without any serious complications. Postoperative angiography was performed in 87.5% within 1 month after operation. The patency rate was 96.6%.
  
  
  CONCLUSIONS
  These results indicate that complete revascularization can be achieved in OPCAB in patients with diffuse coronary arterial disease. Complete revascularization with in situ arterial conduits only is technically feasible and yields a high early graft patency, even in the off-pump situation.
authors.affiliation: Department of Cadiovascular Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Mimiko
authors.initials: M
authors.lastname: Tabata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Niinami
authors.forename: Yuji
authors.initials: Y
authors.lastname: Suda
authors.forename: Akihito
authors.initials: A
authors.lastname: Sasaki
authors.forename: Masato
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Ryota
authors.initials: R
authors.lastname: Asano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ikeda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takeuchi
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D024405:Gastroepiploic Artery / Q000637:transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D017534:Radial Artery / Q000637:transplantation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D013895:Thoracic Arteries / Q000637:transplantation; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency