Our Initial Results of Off-pump Coronary Artery Bypass Grafting

Abstract

Background. On-pump coronary artery bypass grafting (CABG) remains a procedure of choice in patients with ischemic heart disease despite nearly two decades of utilization of off-pump techniques. Nearly all aspects of off-pump CABG operations are still debatable, including indications and contraindications to this procedure. We report here our initial experience with routine application of off-pump CABG in patients with ischemic heart disease. Methods. Results of 96 off-pump CABG procedures performed from May 2015 to date are analyzed. Preoperative demographic and clinical data, intraoperative data and results of postoperative course are analyzed. Our results are compared with the results of other authors and mortality rates are compared to predicted by risk-stratification system “EuroScore” values. Results. The mean number of distal anastomoses was 3.01 +/- 0.07 per patient. In 75 (78.1%) patients we constructed 3 or more grafts, in 22 cases (23%) - we used complex types of surgical technique (sequential, “Y-graft” or “T-graft”). 28 (29.2%) patients required inotropic support in ICU for initial recovery with an average duration of 3.14 +/- 0.74 hours. In 3 (3.1%) patients in the postoperative period were episodes of sustained atrial fibrillation. In 1 (1.04%) patient course of OPCABG procedure was complicated with emergent conversion to on-pump CABG. Mortality was 1.04% (1 patient). Conclusions. A modern OPCABG approach offers low mortality, excellent clinical outcomes, and does not come at the price of less complete revascularization.