Off-pump surgery and alternatives to standard operation in redo coronary surgery

Journal of Cardiac Surgery
Michael J Mack

Abstract

Reoperative coronary artery bypass grafting (CABG) has been associated with higher mortality and morbidity than first-time CABG. Off-pump surgery has been introduced in an effort to reduce morbidity associated with traditional on-pump CABG. However, these techniques present unique challenges in the reoperative setting. A review of our experience was undertaken to determine safety, efficacy, and technical challenges in beating heart reoperative CABG. From January 1999 through April 2003 reoperative CABG procedures performed by a single surgeon were treated on an "intention to treat" basis without cardiopulmonary bypass. A standardized operative technique employing suction stabilization and exposure devices were used for sternotomy procedures with stabilization devices employed for limited access single-vessel revascularization. Eighty-six of eighty-seven (99%) consecutive patients undergoing reoperative CABG had the procedure initiated off-pump. There were 24 of 62 females/males (28%/72%) with a mean age of 64.3 (34 to 92). Eighty-one of eighty-six (94.2%) procedures were successfully completed off-pump. Five (5.8%) conversions were due to hemodynamic instability, inability to dissect dense adhesions (2), inability to locate an ...Continue Reading

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Citations

Jan 1, 2007·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Cullen D MorrisRobert A Guyton
Aug 25, 2012·The Journal of Thoracic and Cardiovascular Surgery·Tsuyoshi KanekoLawrence H Cohn
Nov 28, 2009·Seminars in Thoracic and Cardiovascular Surgery·Steven J Hoff
May 12, 2007·Mayo Clinic Proceedings·Dumbor L NgaageHartzell V Schaff
Mar 14, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Masahiro DohiUNKNOWN Japan Cardiovascular Surgery Database
May 11, 2010·Expert Review of Cardiovascular Therapy·Shahzad G Raja, Mohamed Amrani
Sep 11, 2014·The Korean Journal of Thoracic and Cardiovascular Surgery·Yu Rim ShinKyung-Jong Yoo
May 16, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Vito D BrunoRaimondo Ascione

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