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Beating heart coronary artery bypass grafting

Results from 402 patients and the usefulness of gastroepiploic artery composite grafting

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Abstract

Objectives: We have studied the results of 402 consecutive cases of beating heart coronary artery bypass grafting (CABG) and evaluated the usefulness of gastroepiploic artery (GEA) composite grafts. Methods: Between March 1993 and August 2001, 402 patients underwent beating heart CABG. They were 321 male and 81 female patients, aged 17 to 88 (mean 66) years. Beating heart CABG was facilitated by mechanical stabilization with a doughnut stabilizer, a newly designed sternal retractor and a new coronary perfusion system. Minimally invasive direct coronary artery bypass (MIDCAB) was performed in 206 patients (the MIDCAB Group), and beating heart CABG with median sternotomy (OPCAB) was performed in 196 patients (the OPCAB Group). Results: Definite off-pump CABG was accomplished in 381 patients. 21 patients (5%) were converted to on-pump beating heart CABG using percutaneous cardiopulmonary system via femoral vessels because of hemodynamic instability. There was 1 operative mortality (0.2%). There was perioperative myocardial infarction in 2 (0.5%), and cerebral infarction in 3 (0.7%). The rate of complete revascularization was 78% in the MIDCAB Group and 97% in the OPCAB Group. The mean number of anastomoses was 1.6 in the MIDCAB Group and 3.3 in the OPCAB Group. The early graft patency was 99.1% in a left internal thoracic artery graft, 97.0% in a right internal thoracic artery graft, 96.5% in GEA, 98.2% in a radial artery graft, and 94.2% in a vein graft. A GEA composite graft was used in 55 of the 168 patients who received GEA grafting. The mean number of anastomoses for the GEA composite graft was 1.6±0.6 per patient. The graft patency rate was 94.6% (53/56) for GEA and 98.6% (72/73) for the radial artery used as a composite graft. Conclusion: A consecutive series of beating heart CABG was performed safely and effectively with a low mortality rate and low morbidity rate. Beating heart CABG could be performed in all patients, and definite off-pump CABG was accomplished in 95% of them. In order to aim for complete revascularization, GEA composite graft was found to be effective since it required a low mean number of 1.6 anastomoses and a satisfactory patency rate at the same time.

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References

  1. Suma H, Wanibuchi Y, Terada Y, Fukuda S, Takayama T, Furuta S. The right gastroepiploic artery graft: Clinical and angiographic midterm results in 200 patients. J Thorac Cardiovasc Surg 1993; 105: 615–23.

    PubMed  CAS  Google Scholar 

  2. Takahashi M, Yamamoto S, Tabata S. Immobilized instrument for minimally invasive direct coronary artery bypass: MIDCAB doughnut. J Thorac Cardiovasc Surg 1997; 114: 680–2.

    Article  PubMed  CAS  Google Scholar 

  3. Nakao T, Kawaue Y. Effect of coronary revascularization with the right gastroepiploic artery: Comparative examination of angiographic findings in the early postoperative period. J Thorac Cardiovasc Surg 1993; 106: 149–53.

    PubMed  CAS  Google Scholar 

  4. Grandjean JG, Voors AA, Boonstra PW, den Heyer P, Ebels T. Exclusive use of arterial grafts in coronary artery bypass operations for three-vessel disease: Use of both thoracic arteries and the gastroepiploic artery in 256 consecutive patients. J Thorac Cardiovasc Surg 1996; 112: 935–42.

    Article  PubMed  CAS  Google Scholar 

  5. Nishida H, Tomizawa Y, Endo M, Koyanagi H, Kasanuki H. Coronary artery bypass with only in situ bilateral internal thoracic arteries and right gastroepiploic artery. Circulation 2001; 104 (Suppl I): 76–80.

    Google Scholar 

  6. Ochi M, Bessho R, Saji Y, Fujii M, Hatori N, Tanaka S. Sequential grafting of the right gastroepiploic artery in coronary artery bypass surgery. Ann Thorac Surg 2001; 71: 1205–9.

    Article  PubMed  CAS  Google Scholar 

  7. Sato T, Isomura T, Suma H, Horii T, Kikuchi N. Coronary artery bypass grafting with gastroepiploic artery composite graft. Ann Thorac Surg 2000; 69: 65–9.

    Article  PubMed  CAS  Google Scholar 

  8. Amano A, Hirose H, Takahashi A, Nagano N. Coronary artery bypass grafting using the radial artery: Midterm results in a Japanese institute. Ann Thorac Surg 2001; 72: 120–5.

    Article  PubMed  CAS  Google Scholar 

  9. Abraham R. Does avoidance of cardiopulmonary bypass decrease the incidence of stroke in diabetics undergoing coronary surgery? Heart Surg Forum 2001; 4: 1–6.

    Google Scholar 

  10. Anderson RE, Li TQ, Hindmarsh T, Settergren G, Vaage J. Increased extracellular brain water after coronary artery bypass grafting is avoided by off-pump surgery. J Cardiothorac Vasc Anesth 1999; 13: 698–702.

    Article  PubMed  CAS  Google Scholar 

  11. Czemy M, Baumer H, Kilo J, Zuckermann A, Grubhofer G, Chevtchik O, et al. Complete revascularization in coronary artery bypass grafting with and without cardiopulmonary bypass. Ann Thorac Surg 2001; 71: 165–9.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of General and Cardiothoracic Surgery, Kanazawa University Hospital, 13-1 Takaramachi, 920-8641, Kanazawa, Japan

    Hirofumi Takemura MD, Go Watanabe MD, Masao Takahashi MD, Shigeyuki Tomita MD & Kouichi Higashidani MD

Authors
  1. Hirofumi Takemura MD
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  2. Go Watanabe MD
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  3. Masao Takahashi MD
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  4. Shigeyuki Tomita MD
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  5. Kouichi Higashidani MD
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Read at the Fifty-fourth Annual-Meeting of the Japanese Association for Thoracic Surgery, Panel discussion, Osaka, October 3–5, 2001.

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Takemura, H., Watanabe, G., Takahashi, M. et al. Beating heart coronary artery bypass grafting. Jpn J Thorac Caridovasc Surg 51, 173–177 (2003). https://doi.org/10.1007/s11748-003-0027-2

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  • DOI: https://doi.org/10.1007/s11748-003-0027-2

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