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Coronary artery bypass grafting on the beating heart: 13-years experience in a single center

Background

The relative value of off-pump coronary bypass (OPCAB) surgery as compared to conventional coronary artery bypass operation is still debated. We started a prospective study in 2000 with the aim of using exclusively OPCAB for surgical myocardial revascularization in a single center. The present report analyzes the 13-years results of this approach in a large consecutive patient population.

Methods

Of the 6111 coronary bypass operation performed in our center between January 2000 and December 2012, 5472 were carried out off-pump. Since 2004 OPCAB surgery was performed in more than 99% of cases, conventional CABG was reserved for patients in cardiogenic shock. The OPCAB approach consisted of the use of a single pericardial sling, pressure stabilizing device, aortocoronary shunt and elastic snares. Prophylactic intra-aortic balloon pump counter-pulsation was used in 495 (9%) of cases.

Results

The OPCAB hospital mortality was 1.5% (85/5472). Perioperative myocardial infarction occurred in 60 (1.1%), stroke in 85 (1.2%), major adverse cardiac event in 132 (2.4%) cases. 121 patients needed reoperation for bleeding (2.2%). The mean length of hospital stay was 9.9 (SD 8.5) days.

Conclusions

The shift towards beating-heart surgery provides acceptable results, but does not eliminate perioperative mortality and morbidity.

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Correspondence to G Bogáts.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Bogáts, G., Hegedüs, Z., Bitay, M. et al. Coronary artery bypass grafting on the beating heart: 13-years experience in a single center. J Cardiothorac Surg 8, O172 (2013). https://doi.org/10.1186/1749-8090-8-S1-O172

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Keywords

  • Coronary Artery Bypass
  • Bypass Operation
  • Cardiogenic Shock
  • Major Adverse Cardiac Event
  • Adverse Cardiac Event