Is Single LIMA-LAD Bypass Appropriate for OPCAB Training?

The impact of the surgeon’s experience on outcomes following off-pump coronary artery bypass grafting (OPCAB) is widely known. However, there is a lack of safe and effective strategies for OPCAB training. In this study, a total of 180 patients who underwent an off-pump isolated single coronary bypass of the left anterior descending artery (LAD) using the left internal mammary artery (LIMA) as an in-situ graft via median sternotomy were analyzed. Outcomes were compared in two groups: operations performed by residents in training under supervision (group 1: n = 63) and experienced surgeons (group 2: n = 117). Trainees were already experienced in on-pump coronary artery bypass grafting. There was no significant difference in the rate of major adverse cardiac and cerebrovascular events between the two groups. The authors conclude that a single off-pump LAD bypass might be a reasonable training strategy for OPCAB.