ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Evaluation of the clinical results of off-pump coronary artery bypass surgery in patients with left main or osteal coronary lesions
Naz Bige Aydın1, Tufan Şener 1, Tansel Türkoğlu 1, Asuman Süzer 2, Hüseyin Maçika 2, Recep Öztürk 3, Tamer Akbulut 3, Hakan Gerçekoğlu1
1Dr. Siyami Ersek Hastanesi Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
2Dr. Siyami Ersek Hastanesi Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Anestezi Kliniği, İstanbul
3Dr. Siyami Ersek Hastanesi Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İstanbul
Background: We evaluated the results of beating heart coronary artery bypass grafting without cardiopulmonary bypass in patients with left main coronary artery disease or osteal lesions.

Methods: Between January 2001 and April 2004, a total of 26 patients (19 males, 7 females: mean age 64±4 years; range 45 to 68 years) with left main coronary artery disease (≥50% stenosis) or osteal lesions underwent off-pump coronary artery bypass grafting. Three patients had left osteal, one patient had both right and left osteal, and 22 patients had left main coronary artery disease. Evaluations included the following: creatine phosphokinase-MB levels before and at 2 and 24 hours after surgery; electrocardiographic features before and after surgery (1st hour, 1st and 6th days); inotropic and intraaortic balloon pump (IABP) requirements; duration of extubation; lengths of intensive care unit and hospital stays, mortality and morbidity, and follow-up data within the first 30 days.

Results: Urgent or emergent surgery was performed in 12 patients. Only one patient who underwent emergent operation due to low cardiac output and postinfarction angina needed inotropic support and IABP. This patient was discharged with recovery. No postoperative morbidity was observed in the remaining 25 patients except for two cases with atrial fibrillation. The mean hospital stay was six days. There were no rehospitalization, morbidity or mortality within the first 30 days of follow-up.

Conclusions: Our results demonstrate that off-pump coronary artery bypass grafting is a safe procedure in patients with left main coronary artery disease and osteal lesions.

Keywords : Cardiopulmonary bypass; coronary artery bypass, off-pump
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