Off-Pump Coronary Artery Bypass Surgery - Initial Experience in Gdansk: A Brief Review

(#2002-39993 ... March 15, 2002)

Luther Keita, MD, Lech Anisimowicz, MD, PhD

Department of Cardiac Surgery, Medical University of Gdansk, Gdansk, Poland

ABSTRACT

Background: Before the introduction of cardiopulmonary bypass (CPB), coronary artery bypass grafting (CABG) procedures were performed on a beating heart. In 1967, Kolessov first reported "off-pump" revascularization of the left anterior descending artery (LAD). This technique was later abandoned when the use of cardioplegia and the heart-lung machine allowed a motionless and bloodless operative field. This study reports our initial clinical experience in off-pump coronary bypass surgery performed at the Department of Cardiac Surgery of the Medical University of Gdansk, Poland.

Methods: This study enrolled all consecutive patients who were operated on at our institution without CPB between January 1998 and December 2001. Patients were selected for the off-pump procedure individually by the surgeon. Demographics, operative procedures, postoperative mortality, morbidity, and early outcomes were analyzed. The observation period included 30 postoperative days.

Results: An average of 1.8 grafts per patient were completed. Conversion to CPB was required in 4.1% of patients. Complete revascularization was attained in 91% of the procedures. Surgical mortality was 1.3% and perioperative myocardial infarction was reported in 2.4%.

Conclusions: In selected patients, off-pump CABG may be used as a suitable and safe alternative to conventional on-pump coronary surgery and permits complete revascularization with comparable short-term results.

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