Off-Pump Coronary Bypass Surgery Using Two Internal Thoracic Arteries

Pavel A. Shilenko, Yurii A. Schneider, Men-De Tsoi, Andrei S. Kotcienko, Aleksander A. Pavlov

FGBU FCHMT, Kaliningrad, Russia

Date, time and location: 2018.05.25 15:30, Congress Hall, 2F–A

Abstract

Objective: Coronary artery bypass grafting (CABG) is the preferred method of myocardial revascularization in patients with multifocal coronary artery disease. Most surgeons still don't want to use two internal thoracic artery in off-pump surgery because they believe this process is technically more difficult, time-consuming and associated with a higher risk of infectious complications.

Materials and Methods: In the period from 09.2012 to 11.2017 in our clinic performed 598 operations isolated Off-pump coronary artery bypass grafting using two internal thoracic arteries. We made an analysis of the results of these operations on several criteria: patient's age, the number of conduits, the volume of blood loss (ml), hospital mortality, perioperative myocardial infarction, the incidence of non-infarction heart failure, resternotomy about bleeding, the frequency of infectious complications from the sternum (minor infection, mediastinitis), the incidence of neurological complications (stroke).

Results: The average age of patients was 65.5 years. The average operation time: isolated off-pump CABG - 146 minutes, The average number of grafts -2.9. In all patients was observed low incidence of myocardial infarction in the early postoperative period (4 patients (0,7%)). The average volume of intraoperative blood loss was 470 ml. Infectious complications of the sternum was observed in 8 (1.3%) patients. It was performed 14 (2.3%) resternotomy about bleeding. Stroke in the early postoperative period was 0%.There were no lethal outcomes.

Conclusion: Isolated CABG using 2 ITA immediately after surgery accompanied by low incidence of heart failure, perioperative myocardial infarction, resternotomy about bleeding, infectious complications of the sternum (minor infection, mediastinitis), intraoperative blood loss, need for transfusion of blood components, neurological complications.