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.