engleski

Multiple Arterial Off-pump Coronary Artery Bypass Grafting: A 5-year Experience with Clinical Results

BACKGROUND: The use of arterial grafts combined with off-pump coronary artery bypass (OPCAB) procedure offers many advantages, but most of them are still to be proved in long-term studies. We present our 5-year experience in combining these two strategies in coronary surgery. METHODS: From February 1998 to December 2002 we have operated on 155 patients (146 men and 9 women) for multiple arterial graft myocardial revascularization. All procedures were performed as OPCAB grafting using internal mammary and radial arteries. The mean &plusmn ; SD was 58 &plusmn ; 9 years for patient age, 57 &plusmn ; 11% for left ventricle ejection fraction and 2.3 &plusmn ; 1.9 for the EuroScore. We reviewed perioperative and postoperative data and in-hospital mortality in our patients. RESULTS: A total of 356 distal anastomoses were created, an average of 2.3 per patient. The left internal mammary artery was used as a graft in 153 patients (98%), the right internal mammary artery was used in 13 patients (8%) and the radial artery was used in 146 patients (94%). No venous grafts were used. There were 4 reopenings (2.6%) because of mediastinal bleeding. Four patients (2.6%) experienced perioperative myocardial infarction, and 2 patients (1.3%) had permanent neurological dysfunction. Five patients (3.2%) died in hospital within 30 days. CONCLUSION: Our experience shows that arterial myocardial revascularization can be safely performed as an OPCAB procedure, even in the treatment of multiple-vessel coronary disease. The long-term benefit for patients is to be evaluated in future.

arterial revascularization; off-pump coronary artery bypass grafting; morbidity and mortality

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