Off-Pump Coronary Surgery — Results of Over 100 Cases Done by Trainees in a Single Institution Over One Year

(#2001-7226 ... June 27, 2001)

Massimo Griselli, Clyde Saldanha, Ashok Cherian, Brian Glenville, Rex Stanbridge

St Mary's Hospital, Paddington, London, UK

Presented at the Fourth Annual Scientific Meeting of the International Society for Minimally Invasive Cardiac Surgery, June 27-30, 2001, Munich, Germany.

INTRODUCTION

Beating heart surgery is now an established procedure for myocardial revascularisation. With improvements in technique and technology it is now possible to safely perform off-pump surgery in almost all patients referred for CABG — both elective and non-elective [Roy 2001, Varghese 2001]. It has been demonstrated that off-pump surgery can be safely taught to trainees, but these cases were selected [Karamanoukian 2000, Caputo 2001]. For off pump surgery to be accepted as mainstay treatment, it is necessary to demonstrate that junior surgeons can achieve good results operating on non selected patients. In this context it should be noted that previously reported good results with off pump surgery may reflect the fact that operations have been carried out by very experienced surgeons [Hart 2000]. In our institution the trainees traditionally do high risk and nonelective cases. Once they have been trained in off-pump surgery techniques, the trainees exercise their own judgement as to whether an individual case is better done on or off pump. The results of cases done by these trainees are therefore relevant and applicable to the majority of cardiothoracic surgeons.

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