| Avoidance of Aortic Side-Clamping for Proximal Bypass Anastomoses: Better Short-term Outcome? | |
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MedLine Citation:
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PMID: 22167762 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Objectives: The benefit of off-pump coronary artery bypass (OPCAB) surgery may be reduced by strokes caused by microemboli produced after aortic side-clamping for proximal bypass anastomoses. The Heartstring device allows constructing proximal bypass anastomoses without side-clamping of the aorta.Methods: This retrospective study describes 260 consecutive patients who underwent OPCAB surgery; 442 proximal anastomoses were performed with the Heartstring device in this series. Ten percent of the patients were randomly sampled before discharge to undergo a coronary angiogram for assessment of graft patency.Results: Intraoperative Doppler measurements confirmed regular bypass function. Early mortality occurred in 4 patients (1.5%), and stroke occurred in 2 patients (0.8%). Device-related bleeding was negligible, and there were no cases of aortic dissection. Perioperative ischemia occurred in 8 patients (3.1%). Predischarge coronary angiography evaluations in 25 of the patients (of 260) showed that all 42 Heartstring-assisted anastomoses (of 442) were patent. Conclusions: Clampless performance of proximal bypass anastomoses combined with OPCAB is associated with a very low incidence of stroke complications. Short-term follow-up has shown excellent results regarding bypass patency and other adverse events. Prospective randomized trials are required to confirm the advantage of this technique. |
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Authors:
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Markus J Wilhelm; Thomas Syburra; Lukas Furrer; Jürgen Frielingsdorf; Dragan Odavic; Kirk Graves; Michele Genoni |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The heart surgery forum Volume: 14 ISSN: 1522-6662 ISO Abbreviation: Heart Surg Forum Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100891112 Medline TA: Heart Surg Forum Country: United States |
Other Details:
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Languages: eng Pagination: E360-5 Citation Subset: IM |
Affiliation:
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Clinic for Cardiac Surgery, City Hospital Triemli Zurich, Zurich, Switzerland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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