Graft patency study in off-pump coronary artery bypass surgery

Abstract

Off-pump coronary artery bypass (OPCAB) is known to reduce operative morbidity, intensive care and hospital stay and blood usage. Recent reports have highlighted the poor results after off-pump coronary artery bypass. So, we decided to look at the angiographic patency of our patients at the end of 3 months. Out of 265 patients who underwent isolated primary coronary artery bypass graft surgery (CABG) in a 2-year period at our institution, 118 are the subjects for this study. The anticoagulation and antiplatelet protocols are explained in detail. These patients underwent computerised tomography (CT) of coronary arteries to evaluate the graft patency. The results were studied by a competent radiologist with advanced Windows 4.7 workstation. There were 118 patients with a total of 380 anastomoses for evaluation. Twenty patients (16.95%) had some of their grafts blocked. Out of a total of 380 anastomoses, 24 were found to be blocked (6.3%). Left internal mammary artery had 98.3% patency. Left radial artery showed a patency rate of 96%. Saphenous vein grafts had a patency rate of 91.2%. The anterior and inferior territory grafts were patent in greater than 95% of patients, whereas lateral wall grafts were patent in 86% of patients. There was no mortality in this series. One patient reported angina. Fifty-eight patients had a treadmill test and 51 were negative and 7 had positive results for inducible ischemia. OPCAB is a safe technique with acceptable clinical outcome and angiographic patency in experienced hands.