Off-pump total arterial revascularization: our experience
| Autor: | Francisco Portela, Javier García‐Carro, José V. Valle, José J. Cuenca, Francisco Vázquez, R. Tarrio, Vicente Campos, Valdemar Gomes, Fernando Rodríguez, Belén Adrio, Alberto Juffé, José M. Herrera |
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| Rok vydání: | 2004 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Coronary Artery Bypass Off-Pump Coronary Disease Anastomosis Cohort Studies Internal medicine medicine Humans Myocardial infarction Stroke Internal Mammary-Coronary Artery Anastomosis Aged Ejection fraction medicine.diagnostic_test business.industry Extracorporeal circulation Middle Aged medicine.disease Mediastinitis Surgery medicine.anatomical_structure Treatment Outcome Angiography Cardiology Female Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Journal of cardiac surgery. 19(5) |
| ISSN: | 0886-0440 |
| Popis: | BACKGROUND AND AIM Off-pump coronary artery bypass grafting with both the internal thoracic arteries, such as the Tector technique, can reduce the morbidity associated with extracorporeal circulation and aortic cross-clamp. The aim of the present study is to describe our experience and the results obtained. METHODS From April 1998 to December 2003, the off-pump Tector technique was performed on 743 patients, of whom 621 were male (83.5%), with a mean age of 65.3 +/- 9.5 years (23-90). Preoperative risk factors were diabetes mellitus in 29.5% and peripheral vasculopathy in 14.7% of the patients. Angiography showed left main disease in 25.6% and triple-vessel disease in 50.3% of the patients, with a mean ejection fraction of 60%+/- 13% (23-88). Both the internal thoracic arteries were harvested using the skeletonization technique and were anastomosed as "Y" or "T" grafts. Intraoperative graft patency was checked using a Doppler flowmeter. RESULTS A total of 2028 distal anastomoses were performed, the average being 2.7 (1 to 5) per patient. At least three distal anastomoses were undertaken in 62% of the patients. Postoperative complications included atrial fibrillation in 40 patients (5.4%), myocardial infarction in 24 (3.2%), mediastinitis and reoperation for bleeding in 7 (0.9%) and stroke in 3 (0.4%). Twenty-four patients (3.2%) died in the first month postoperatively. CONCLUSIONS The off-pump Tector technique appears to be safe, showing a low surgical morbidity. |
| Databáze: | OpenAIRE |
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