Multi-Vessel Off-Pump Coronary Artery Bypass Grafting Can Be
Taught to Trainee Surgeons
(#2001-8877 ... June 27, 2001)
David Jenkins FRCS, Sharif Al-Ruzzeh FRCS, Shahid Khan
FRCS, Mahmoud Bustami MRCP, Thomas Modine MD, Magdi Yacoub FRCS,
Charles Ilsley FRCP, Mohamed Amrani FETCS
The National Heart and Lung Institute, Department of
Cardiothoracic Surgery, Harefield Hospital, Middlesex, United
Kingdom
Presented at the Fourth Annual Scientific Meeting of the
International Society for Minimally Invasive Cardiac Surgery, June
27-30, 2001, Munich, Germany.
ABSTRACT
Background: Although, Off-Pump Coronary Artery Bypass
(OPCAB) surgery is being increasingly explored and practised in
many cardiac units worldwide, there have been only few reports
documenting the training of surgeons in this new technique. The
purpose of this study was to address the reproducibility of the
OPCAB in a unit where this technique is used extensively.
Methods: Registry data, notes and charts of 64 patients who
were operated on by four trainee cardiac surgeons over a period of
thirteen months at Harefield Hospital, were reviewed
retrospectively. These trainees were part of an accredited
training programme for cardiothoracic training and were trained by
a single consultant trainer in a cardiac unit after it has had an
established recent experience in performing non-selective OPCAB
for all coming-in patients. Five (7.8%) patients (with 17 distal
anastomoses) consented and underwent early postoperative
angiography to check the quality of the grafts and anastomoses.
Results: The mean age of the study patients was 65.6 and
the mean Parsonnet score was 9.4. There was a mean of 2.9 grafts
per patient and circumflex territory anastomoses were performed in
48 (75%) patients. No operation required conversion to
Cardiopulmonary Bypass (CPB). Angiography of the five patients
revealed satisfactrory seventeen (100%) distal anastomoses.
Conclusion: With appropriate training, it is possible for
trainees to learn OPCAB and perform multi-vessel revascularization
in relatively high-risk patients with good results.
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