Folia Medica Indonesiana
ISSN 0303-7932
Vol. 38 / No. 2 / Published : 2002-04
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Original Article :
Off-pump coronary artery bypass surgery with the octopus: early experience of 21 patients
Author :
Abstract :
Introduction: The Off-Pump Coronary Artery Bypass (OPCAB) surgery is very similar to the conventional Coronary Artery Bypass Grafting (CABG) procedure. This technique is developing rapidly and becoming established in many hospitals. This is also widely applicable in the developing countries including Indonesia. Objective: To evaluate the early experience of OPCAB and its correlation to the patients’ selection, technique, complication and prognosis. Material and Methods: Twenty-one patients underwent OPCAB surgery consecutively from January 2000 until December 2000 at our institution. Analysis was undertaken on data prospectively inserted in the patient’s medical record. The technique of OPCAB is done via a median sternotomy on a beating heart with octopus II or III. Results: Twenty-one patients consisting 20 males (95.24 %) and 1 female (4.76 %) were further analyzed. The age ranged between 42 – 74 years (56.4 ± 7.9) and the ejection fraction was 35% - 74% (55.8 ± 9.5%). There were single-vessel disease in 2 patients, double-vessel disease in 10 patients and triple-vessel disease in 9 patients. Distal anastomosis was 1 – 4 (2.4 ± 0.8) and proximal anastomosis 0 – 3 (1.7 ± 0.9). Total distal anastomoses were 51. Total ICU stay demonstrated 34.6 ± 8.7 (26 – 48) hours and total hospital stay after operation showed 6.3 ± 1.6 (4 – 10) days. Two patients (9.52%) had peri-operative atrial fibrillation. Intra operative conversion to cardiopulmonary bypass was necessary in 4 patients (19.05%). It was caused by bleeding in two patients, dysrhythmia in 1 patient and technique difficulties: distal anastomosis to circumflex branch. There was no early – post-operative re-operation because of bleeding or cardiac tamponade or graft failure. There was no early post-operative mortality in this series (0%). Late mortality rate was in 1 patient (4.76%) because of myocardial failure. Conclusions: Coronary artery bypass surgery without using cardiopulmonary bypass is safe to achieve good early result. This technique is applied to reduce the operation cost and the hospital stay, especially in the developing countries including Indonesia.
Keyword :
Coronary artery disease, off – pump CABG,
References :
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Volume : 38 / No. : 2 / Pub. : 2002-04 |
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