[A trial to improve operative results of coronary artery bypass grafting (CABG); off-pump CABG (OPCAB) as standard procedure].
To improve operative results of coronary artery bypass grafting (CABG), off-pump CABG (OPCAB) was performed as standard procedure in 220 cases at Toho University Omori Medical Center between 1999 and 2008. In the early group, OPCAB was performed in 94 cases, minimally invasive direct coronary artery bypass (MIDCAB) in 5 cases (off-pump rate of was 81.1%), on-pump beating coronary artery bypass (CAB) in 4 cases, and on-pump arrest CAB in 19 cases. In the late group, OPCAB was done in 79 cases (80.6%), on-pump beating CAB in 8 cases, and on-pump arrest CAB in 11 cases. One patient died because of multiple organ failure after OPCAB for acute coronary syndrome (ACS) in the early group. There was no surgical death in the late group. The overall surgical mortality rate was 0.45%. In the late group, 69 PAS x Port systems were used in 53 cases for proximal anastomosis of the saphenous vein graft (SVG). The patency rate was 97.8% which was confirmed by CAG and or 3-dimensional computed tomography (3D-CT) between 10 days to 23 months after operation. OPCAB could be performed for over 80% of CABG candidates with very low mortality. To improve clinical results, on-pump beating CAB and on-pump arrest CAB should be selected in cases of poor cardiac performance or ischemic condition at the pre- and during operation. The use of proximal anastomosis device reduces the stress of surgeon and the time of anastomosis, those benefits make the excellent postoperative course with reduced postoperative cerebral infarction.
Watanabe
Y
Y
Division of Cardiovascular Surgery, Toho University Omori Medical Center, Tokyo, Japan.
D000368:Aged; D001026:Coronary Artery Bypass / Q000401:mortality; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome