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ABSTRACT 28
TOWARD COMPLETE REVASCULARIZATION IN OFF-PUMP
CABG
Kit Arom, Robert Emery, Thomas Flavin, Vibhu Kshettry,
Cardiac Surgical Associates, Minneapolis, MN, USA
OBJECTIVE: On-pump coronary artery bypass surgery is a
gold standard for surgical treatment of coronary artery disease.
Ability to achieve optimal revascularization with off-pump technique
is questioned.
METHODS: CABG with first-op, elective, full sternotomy
from 01-01-1998 through 03-31-2000 numbered 2327 on-pump and 675
off-pump patients. Vessels with stenosis (>50%) and >1.5mm
in size were reviewed for graft placement.
RESULTS: Two percent of on-pump patients had single graft,
17% had 2, 45% had 3, 27% had 4, 8% had 5, 1% had 6 and 0.2% had
7 grafts compared with 8%, 26%, 36%, 23%, 6%, 1% and 0.1% respectively
for off-pump.
MEAN VESSEL SIZE AND % OF VESSELS GRAFTED
|
On-Pump
|
| |
LAD
|
D1
|
D2
|
IM
|
OM1
|
OM2
|
OM3
|
RCA
|
PDA
|
LVB
|
|
Size
|
1.6
|
1.5
|
1.4
|
1.6
|
1.6
|
1.6
|
1.6
|
1.8
|
1.5
|
1.5
|
|
%grafted
|
78*
|
49*
|
15
|
47
|
61
|
35
|
20
|
36
|
41*
|
24
|
|
Off-Pump
|
|
Size
|
1.7
|
1.5
|
1.6
|
1.6
|
1.7
|
1.6
|
1.6
|
2.0
|
1.6
|
1.5
|
|
%grafted
|
86*
|
58*
|
24
|
37
|
66
|
43
|
36
|
33
|
57*
|
26
|
*p< 0.05
CONCLUSION: After the learning period, off-pump approach
does allow surgeon to accomplish optimum revascularization.
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