Technical problems during coronary artery bypass grafting

Abstract

In this paper we have reviewed 300 more or less consecutive coronary artery bypass grafting (CABG) cases with regard to the technical problems that can occur. Only first time revascularisation operations were considered, including those combined with resection of left ventricular (LV) aneurysm and valve replacement. Redo operations were not included. Specific complications related to vein grafting and some miscellaneous problems inherent in open heart surgery are discussed in depth. The morbidity and perioperative mortality are analysed. There was only one perioperative death giving a mortality rate of .3%. 300 first-time CABG operations, including CABGs with resection of LV aneurysm or valve replacement were reviewed in depth to focus on the technical complications encountered whilst the patient was on the operating table. Although CABG is one of the most frequently performed cardiac surgical procedures in the western world, there is still about a 1% mortality rate associated with the operation in the centres doing a large number of these operations and the authors have attempted to highlight those technical complications that contribute to perioperative morbidity and mortality and their management.