engleski

Aorta no-touch technique - a safe option in total arterial revascularization

AIM: To evaluate our overall results using the aorta "no-touch" technique for arterial revascularization and compare them to conventional methods used in total arterial revascularization. PATIENTS AND METHODS: From February 1998 until March 2003, 345 patients underwent total arterial revascularization using IMAs and radial arteries. They were included in prospective non-randomized trial and divided into three groups. "Aorta no-touch" technique was used in 46 patients (group A), 119 patients underwent OPCAB procedure (group B), and 180 patients underwent standard CABG procedure (group C). There were no significant differences in patient's demographics, preoperative risk stratifiction (EuroSCORE) or number of diseased vessels. RESULTS: There were 3 deaths in group A (6, 5%), 4 in group B (3, 3%), and 7 in group C (3, 8%). One patient suffered a stroke in group A , 1 in group B and 2 in group C (overall stroke incidence 1%). Reopening for mediastinal bleeding was neccessary in 1 patient in group A, 3 in group B and 5 in group C. Sternal infection rates were 3% in group A, 7, 5% in group B and 7% in group C and were not linked to IMA harvesting nor diabetes in those patients. None of the differences between groups were statistically significant. CONCLUSION: With low overall mortality rates, low number of neurologic complications and infection, "aorta no-touch" tecnique represents a safe option for total arterial revascularization in patients with substantial risk of stroke after bypass grafting. It does not carry any additional risk in terms of perioperative mortality or postoperative morbidity.

no-touch technique; neurological complications; infection

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