Graft patency study in off-pump coronary artery bypass surgery

  • Arani Raghavendra Rao Raghuram
  • Krishnaswamy Subramanyan
  • Subbiah Sivakumaran
  • Purushothaman Chandrasekar
  • Subramanian Harikrishnan
  • Govindarajan Arunkumar
Original Article
First Online:
Received:
Revised:
Accepted:

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

OPCAB is a safe technique with acceptable clinical outcome and angiographic patency in experienced hands.

Keywords

Coronary artery bypass grafting Left internal mammary artery Radial artery 
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Notes

Acknowledgements

We would like to thank Mr. Pavithran, Ms. Ambika and Ms. Divya for their secretarial assistance in tabulation of results and typing works.

Funding

No funding from any agency has been received for this study.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all the patients before the procedure.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2017

Authors and Affiliations

  • Arani Raghavendra Rao Raghuram
    • 1
    • 2
  • Krishnaswamy Subramanyan
    • 1
  • Subbiah Sivakumaran
    • 1
  • Purushothaman Chandrasekar
    • 1
  • Subramanian Harikrishnan
    • 1
  • Govindarajan Arunkumar
    • 1
  1. 1.Institute of Cardiac SciencesSRM Institutes of Medical Sciences (SIMS)ChennaiIndia
  2. 2.ChennaiIndia

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