Off-pump coronary artery bypass surgery in left main coronary artery disease: the last frontier?

Revista Brasileira de Cirurgia Cardiovascular

João C. Leal²  Moacir F. Godoy²  Domingo M. Braile²  Enio Buffolo¹ 

[1] ,Medical School, São José do Rio Preto

关键词: Myocardial revascularization;    Coronary disease;    Left main coronary artery;    Revascularização miocárdica;    Coronariopatia;    Lesão de tronco coronariano esquerdo;   

DOI  :  10.1590/S0102-76382003000200004

来源: SciELO

【 摘 要 】

OBJECTIVE: Our aim is to demonstrate the possibility of applying the alternative tactic of off-pump coronary artery bypass surgery to left main coronary artery disease and to assess the long-term results over a 5-year follow-up period. METHODS: Among 210 subjects submitted to off-pump coronary artery bypass, 119 (56.7%) were male. Their ages ranged from 32 to 81 years with a mean age of 59.7. A left coronary artery branch lesion of at least 70% was demonstrated in 48 (22.8%) of the individuals and a right coronary lesion was associated in 10 (20.8%) of the cases. RESULTS: A breakdown of the number of grafts per patient was: 2 for 52.1%, 3 for 43.5% and 4 for 4.4% of the surgeries. All of the patients were extubated in the intensive care unit after a 6-hour stay. No left ventricular dysfunction was evidenced after a seven-day total hospitalization period. One death, due to cardiac problems, occurred after one month. Follow-up with clinical cardiac evaluation was total until 60 months with a survival rate at 5 years of 96.0% ± 3.9%. CONCLUSION: In left main coronary artery disease, which is feared by cardiac surgeons, we believe that the technique of off-pump coronary artery bypass could be very useful. If the patients are hemodynamically stable and undergo an elective operation, the operative period can be passed in a safe and tranquil manner.

【 授权许可】

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