Early angiographic results of multivessel off-pump coronary artery bypass grafting.
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.
Tabata
Mimiko
M
Department of Cadiovascular Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Niinami
Hiroshi
H
Suda
Yuji
Y
Sasaki
Akihito
A
Yamamoto
Masato
M
Asano
Ryota
R
Ikeda
Masahiro
M
Takeuchi
Yasuo
Y
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