title: Management of patients with a calcified aorta or low ejection fraction undergoing multivessel coronary revascularization.
abstract: Off-pump coronary artery bypass surgery (OPCAB) provides an alternative method of surgical revascularization by allowing coronary anastomoses to be constructed without the use of cardiopulmonary bypass and without manipulation of the aorta. The presence of a calcified aorta is one of the strongest indications for OPCAB because both distal and proximal anastomoses can be performed without cannulation or clamping of the aorta. In patients with left ventricular dysfunction, OPCAB techniques allow for revascularization without the need for global myocardial ischemia associated with cardioplegic arrest.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: W Brent
authors.initials: WB
authors.lastname: Keeling
authors.forename: Michael E
authors.initials: ME
authors.lastname: Halkos
authors.forename: John D
authors.initials: JD
authors.lastname: Puskas
mesh_terms: D000714:Anastomosis, Surgical; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D006305:Health Status Indicators; D006439:Hemodynamics; D006801:Humans; D009204:Myocardial Revascularization; D013318:Stroke Volume; D014463:Ultrasonography; D016277:Ventricular Function, Left