The potential advantage of “no-touch” aortic technique in off-pump complete arterial revascularization

• Published in: International journal of cardiology 2007-01, Vol.114 (1), p.11-15
• Main Authors: Bolotin, Gil, Shapira, Yuval, Gotler, Yakov, Frolkis, Inna V, Ben-Gal, Yanai, Nesher, Nahum, Uretzky, Gideon
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aorta, Thoracic; Biological and medical sciences; CABG; Cardiology. Vascular system; Cardiovascular; Complete arterial revascularization; Coronary Artery Bypass - methods; Coronary Artery Bypass, Off-Pump - methods; Female; Humans; Male; Medical sciences; OPCAB; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Untouched aorta
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2005.11.107

Abstract Objectives Off-pump coronary artery bypass grafting (OPCAB) and complete arterial revascularization without proximal anastomosis to the aorta may decrease neurological events after open-heart surgery. Few reports exist regarding the combination of OPCAB and complete arterial revascularization exploring the theoretical advantage of avoiding manipulation of the aorta. We review our results in 110 patients who underwent multiple grafts off-pump complete arterial revascularization. Methods 110 patients underwent multiple grafts OPCAB complete arterial revascularization, and were compared to 216 patients who underwent traditional multiple grafts on pump CABG. Preoperative renal failure was 12.7% ( n = 14) as compared to 5.1%, ( n = 11, p = 0.01) in the control group and 33.6% ( n = 37) of the patients were 75 years or older as compared to 19.0% ( n = 41, p = 0.003) in the control group. Results The mean number of grafts per patient undergoing multiple OPCAB complete arterial revascularization was 2.3, as compared to 3.11 in the control group ( p < 0.001). The mortality rate was 2.73% as compared to 1.85% (NS) in the control group. The incidence of CVA was 0% as compared to 2.31% ( p = 0.17) in the control group. Conclusions Complete arterial OPCAB revascularization without manipulation of the aorta in high-risk patients can be performed with short-term similar results to conventional CABG and very low neurological complications.