Key result
Off-pump coronary artery bypass was successfully performed without complications in four high-risk patients requiring redo operations or presenting with a calcified ascending aorta.
Why the study?
Does off-pump coronary artery bypass (OPCAB) surgery improve outcomes in high-risk patients undergoing complex coronary artery bypass procedures compared to CABG with cardiopulmonary bypass?
Case Report (n=4)
No
Does off-pump coronary artery bypass (OPCAB) surgery improve outcomes in high-risk patients undergoing complex coronary artery bypass procedures compared to CABG with cardiopulmonary bypass?
OPCAB may offer superior outcomes with reduced morbidity and stroke rates in high-risk patients undergoing complex CABG procedures, such as redo operations or those with a calcified ascending aorta.
May be feasible in select high-risk redo or calcified-aorta cases; leaves open whether OPCAB improves outcomes versus on-pump CABG.
Off-pump coronary artery bypass (OPCAB) surgery is a procedure that is still not widely used by all cardiac surgeons. In the USA about 20-25% of coronary artery bypass graft (CABG) surgery is done offpump. Current literature suggests that both OPCAB and CABG with cardiopulmonary bypass have similar mortality rates, but OPCAB surgery does offer less morbidity, and advantages in terms of mortality and stroke rates in certain high risk patients. We discuss the role of OPCAB surgery in high risk patients, especially redo operations through a left thoracotomy to protect an intact internal mammary artery (LIMA) graft to the left anterior descending artery (LAD) and in patients with a calcified ascending aorta. Four case reports are used as examples and the literature is reviewed, which shows a superior outcome with OPCAB surgery in these complicated cases.
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Harris et al. (2017) conducted a case report in Complex coronary artery disease (n=4). Off-pump coronary artery bypass (OPCAB) was evaluated on Surgical success and recovery. Off-pump coronary artery bypass was successfully performed without complications in four high-risk patients requiring redo operations or presenting with a calcified ascending aorta.
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