Myocardial Stabilization During Off-Pump Coronary Artery Bypass Grafting
The key issues for satisfactory results with off-pump coronary artery bypass grafting (CABG) are accuracy with the anastomosis and safe management of the regionally ischemic myocardium. The greatest challenges confronted during creation of the anastomosis under beating heart conditions include performance of a well-aligned coronary arteriotomy without injury to the vessel back wall, accurately placed toe and heel sutures, and prevention of injury to the fragile edge of the arterial conduit and native artery during suture placement. With the concerted focus and development over the last 2–3 years, substantial headway has been made in these areas. There are now formalized and reproducible techniques to ensure optimal presentation of the myocardium and graft artery, for local immobilization of the myocardium, and to control the anastomotic site. As a result of these developments, the previously held hesitations concerning beating heart CABG have been largely averted.
KeywordsLeft Anterior Descend Anastomotic Site Beating Heart Left Internal Mammary Artery Coronary Bypass Grafting
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