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Myocardial Revascularization in
the Beating Heart
Ruiz, Roberto; Farias, Rubén; Garberi,
Alvarado; Julio; Schiro Gustavo
Sanatorio La Entrerriana, Paraná, Entre Ríos, Argentina
Introduction: Cardiopulmonary bypass (CPB) is known to be associated with deleterious effects in different organ function. To decrease morbidity, coronary artery bypass grafting without CPB (opcab) has been performed as an alternative to conventional technique.
Objective: The aim of this study is to evaluate ours results in this early experience with beating heart surgery.
Methods: From July 1999 to April 2001,53 OPCAB procedures were performed via median sternotomy, using the OCTOPUS® 2 stabilization system. There were 37 male and 17 female patients with a mean age was 64.29 (45-86) years, 26 % with previous PTCA, 28 % myocardial infarction, 26 % left main disease, 20 % diabetes, 4 % CABG and 8 % stroke.
Results: We performed 94 bypass; 17 % triples, 43 % doubles, 40 % singles, 50 to the LAD, 23 to the circunflex, 15 to the RCA, and 6 to the diagonal arteries, with a mean number of 1.84 anastomoses per patient, 72 % using LIMA.
One patient died in early postoperative period for malignant arrhythmia (mortality 1.88 %), another patient had perioperative myocardial infarction due to mammary spasm requiring PTCA. There was not any other complication (deep wound sternal infection, stroke, and atrial fibrillation). Bleeding range was 200 ml without reoperation. The mean range of postoperative stay was 4 days.
In one postoperative month all patients were asymptomatic.
Discussion: Our early experience according with the literature showed the advantages of beating heart surgery avoiding CPB, without decreasing the quality of anastomoses. Further evaluation on late graft patency rates must be needed.
Conclusion: Beating heart surgery is safe and effective accomplishing off-pump grafting of all coronary territories, reduce morbidity, and allow fast recovery with excellent clinical outcomes in short term follow up.
2nd Virtual Congress of Cardiology
Dr. Florencio Garófalo
Dr. Raúl Bretal
Dr. Armando Pacher
Technical Committee - CETIFAC
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