title: [Surgical treatment for ischemic heart disease].
abstract: BACKGROUND
  Surgical treatment for ischemic heart disease (IHD) has changed after the administration of off-pump coronary artery bypass grafting (CABG) [OPCAB] and left ventricular restoration (LVR). We studied the development of the treatment and the surgical results.
  
  
  METHODS
  Since May 2000 when the indication for OPCAB and LVR was defined, surgical treatment for IHD has been performed in 1,251 patients. The age ranged from 32 to 91 (mean 66 +/- 10) years and there were 977 men and 274 women. The elective operation was 1,130 and emergency 121. Definite indication for OPCAB was calcified ascending aorta, significant cerebrovascular disease, hemorrhagic tendency, and single vessel lesion. Conventional CABG (C-CAB) was the first choice and morbidity and surgical results were examined.
  
  
  RESULTS
  OPCAB was performed in 297 (29.9%) and combined operation with CABG was required in 258 patients (20.6%). In elective operation, hospital mortality was one in OPCAB and one in C-CAB. In OPCAB and C-CAB, stroke was none and one, and mediastinitis was 0 and 0, respectively.
  
  
  CONCLUSIONS
  The technique for OPCAB is necessary for CABG; however, it is not appropriate to persist with only OPCAB for CABG. Combined operation is often required with CABG and it is essential to perform precise C-CAB.
authors.affiliation: Department of Cardiovascular Surgery, Hayama Heart Center, Kanagawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Isomura
authors.forename: J
authors.initials: J
authors.lastname: Hoshino
authors.forename: Y
authors.initials: Y
authors.lastname: Fukada
authors.forename: K
authors.initials: K
authors.lastname: Furukawa
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
authors.forename: S
authors.initials: S
authors.lastname: Katahira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery*