Early Result of Off-Pump Coronary Artery Bypass

The advances in surgical techniques and stabilizing devices have made the off-pump coronary artery bypass (OPCAB) popular, and good results have been published. We analyzed the early results of OPCAB performed in our hospital.

Between January 2004 and December 2004, 23 patients underwent OPCAB. There were 14males and 9 females with mean age of 62.6±10.3years. Preoperative diagnoses were unstable angina in 13(57%), acute myocardial infarction in 9(39%), and stable angina in 1(4%). Preoperative angiographic diagnoses were three-vessel disease in 12 (52%), two-vessel disease in 8(35%), one-vessel disease in 1(4%), and left main disease in 2(9%).

The mean number of grafts was 2.6±0.9 per patient. Vessels accessed were left anterior descending artery in 23, diagonal branch in 14, obtuse marginal branch in 9, right coronary artery in 12, and posterior descending artery in 1. Left internal mammary artery were used in 22 patients and bilateral internal mammary arteries were used in 1 patient. There was no operative mortality. Postoperative complications were cerebral vascular accident in 1, postoperative bleeding which required operative management in 2, arrhythmia including atrial fibrillation in 5, and minor operative wound problem in 1. Pre-discharge graft patency was evaluated in 11 patients. One internal mammary artery graft was occluded in 11 internal mammary artery graft evaluated. The patency rate was 91%. Seventeen saphenous vein grafts were patent in 19 saphenous vein grafts and the patency rate was 89%.

Our result of OPCAB is promising and OPCAB is suggested to be the ideal technique with less morbidity and mortality.