Off-pump coronary artery grafting in patients with left main coronary artery disease

Salim S. Virani, Pierluca Lombardi, Hassan Tehrani, Saqib Masroor, Said Yassin, Tomas Salerno, Hooshang Bolooki, Kushagra Katariya

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Left main coronary artery disease (LMCD) is considered a relative contraindication to off-pump coronary artery bypass (OPCAB) grafting. This study evaluates the safety and feasibility of OPCAB in these patients compared to an on-pump group (cardiopulmonary bypass, CPB) with LMCD. Methods: Between January 2000 and July 2002, 95 patients with left main coronary artery stenosis >50% underwent coronary revascularization. Seventy-three unselected patients underwent OPCAB and 22 underwent revascularization using CPB. The techniques used for OPCAB included the use of deep traction sutures in the posterior pericardium and stabilizers to expose the distal coronary targets, Intraluminal coronary shunts were routinely used during construction of the anastomoses. Variables were analyzed using a Student's paired t-test with statistical significance defined as p < 0.05. Results: The mean age in the OPCAB group was 59.9 years and the CPB group 61.8 years (p = 0.54). There were 56 males (77%) in the OPCAB and 18 (82%) in the CPB groups. Mean preoperative left ventricular ejection fraction (LVEF) was 40.3% in OPCAB and 47.3% in CPB (p = 0.015). Average number of grafts was 3.1 in OPCAB and 4.1 in CPB (p = 0.0038). There were no conversions to CPB in those patients initially chosen to undergo OPCAB. There were no early deaths in OPCAB. There was one death in CPB. Mean hospital length of stay was 6.9 days for OPCAB and 9.1 for CPB (p = 0.0159). Conclusions: Patients with LMCD can undergo OPCAB grafting safely and effectively despite reduced LVEF. LMCD should no longer be seen as a contraindication to perform OPCAB grafting.

Original languageEnglish
Pages (from-to)537-541
Number of pages5
JournalJournal of Cardiac Surgery
Volume20
Issue number6
DOIs
StatePublished - Nov 1 2005

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Off-Pump Coronary Artery Bypass
Coronary Artery Disease
Coronary Vessels
Cardiopulmonary Bypass
Coronary Artery Bypass
Stroke Volume
Length of Stay
Coronary Stenosis
Pericardium
Traction
Sutures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Off-pump coronary artery grafting in patients with left main coronary artery disease. / Virani, Salim S.; Lombardi, Pierluca; Tehrani, Hassan; Masroor, Saqib; Yassin, Said; Salerno, Tomas; Bolooki, Hooshang; Katariya, Kushagra.

In: Journal of Cardiac Surgery, Vol. 20, No. 6, 01.11.2005, p. 537-541.

Research output: Contribution to journalArticle

Virani, SS, Lombardi, P, Tehrani, H, Masroor, S, Yassin, S, Salerno, T, Bolooki, H & Katariya, K 2005, 'Off-pump coronary artery grafting in patients with left main coronary artery disease', Journal of Cardiac Surgery, vol. 20, no. 6, pp. 537-541. https://doi.org/10.1111/j.1540-8191.2005.00156.x
Virani, Salim S. ; Lombardi, Pierluca ; Tehrani, Hassan ; Masroor, Saqib ; Yassin, Said ; Salerno, Tomas ; Bolooki, Hooshang ; Katariya, Kushagra. / Off-pump coronary artery grafting in patients with left main coronary artery disease. In: Journal of Cardiac Surgery. 2005 ; Vol. 20, No. 6. pp. 537-541.
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abstract = "Background: Left main coronary artery disease (LMCD) is considered a relative contraindication to off-pump coronary artery bypass (OPCAB) grafting. This study evaluates the safety and feasibility of OPCAB in these patients compared to an on-pump group (cardiopulmonary bypass, CPB) with LMCD. Methods: Between January 2000 and July 2002, 95 patients with left main coronary artery stenosis >50{\%} underwent coronary revascularization. Seventy-three unselected patients underwent OPCAB and 22 underwent revascularization using CPB. The techniques used for OPCAB included the use of deep traction sutures in the posterior pericardium and stabilizers to expose the distal coronary targets, Intraluminal coronary shunts were routinely used during construction of the anastomoses. Variables were analyzed using a Student's paired t-test with statistical significance defined as p < 0.05. Results: The mean age in the OPCAB group was 59.9 years and the CPB group 61.8 years (p = 0.54). There were 56 males (77{\%}) in the OPCAB and 18 (82{\%}) in the CPB groups. Mean preoperative left ventricular ejection fraction (LVEF) was 40.3{\%} in OPCAB and 47.3{\%} in CPB (p = 0.015). Average number of grafts was 3.1 in OPCAB and 4.1 in CPB (p = 0.0038). There were no conversions to CPB in those patients initially chosen to undergo OPCAB. There were no early deaths in OPCAB. There was one death in CPB. Mean hospital length of stay was 6.9 days for OPCAB and 9.1 for CPB (p = 0.0159). Conclusions: Patients with LMCD can undergo OPCAB grafting safely and effectively despite reduced LVEF. LMCD should no longer be seen as a contraindication to perform OPCAB grafting.",
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T1 - Off-pump coronary artery grafting in patients with left main coronary artery disease

AU - Virani, Salim S.

AU - Lombardi, Pierluca

AU - Tehrani, Hassan

AU - Masroor, Saqib

AU - Yassin, Said

AU - Salerno, Tomas

AU - Bolooki, Hooshang

AU - Katariya, Kushagra

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N2 - Background: Left main coronary artery disease (LMCD) is considered a relative contraindication to off-pump coronary artery bypass (OPCAB) grafting. This study evaluates the safety and feasibility of OPCAB in these patients compared to an on-pump group (cardiopulmonary bypass, CPB) with LMCD. Methods: Between January 2000 and July 2002, 95 patients with left main coronary artery stenosis >50% underwent coronary revascularization. Seventy-three unselected patients underwent OPCAB and 22 underwent revascularization using CPB. The techniques used for OPCAB included the use of deep traction sutures in the posterior pericardium and stabilizers to expose the distal coronary targets, Intraluminal coronary shunts were routinely used during construction of the anastomoses. Variables were analyzed using a Student's paired t-test with statistical significance defined as p < 0.05. Results: The mean age in the OPCAB group was 59.9 years and the CPB group 61.8 years (p = 0.54). There were 56 males (77%) in the OPCAB and 18 (82%) in the CPB groups. Mean preoperative left ventricular ejection fraction (LVEF) was 40.3% in OPCAB and 47.3% in CPB (p = 0.015). Average number of grafts was 3.1 in OPCAB and 4.1 in CPB (p = 0.0038). There were no conversions to CPB in those patients initially chosen to undergo OPCAB. There were no early deaths in OPCAB. There was one death in CPB. Mean hospital length of stay was 6.9 days for OPCAB and 9.1 for CPB (p = 0.0159). Conclusions: Patients with LMCD can undergo OPCAB grafting safely and effectively despite reduced LVEF. LMCD should no longer be seen as a contraindication to perform OPCAB grafting.

AB - Background: Left main coronary artery disease (LMCD) is considered a relative contraindication to off-pump coronary artery bypass (OPCAB) grafting. This study evaluates the safety and feasibility of OPCAB in these patients compared to an on-pump group (cardiopulmonary bypass, CPB) with LMCD. Methods: Between January 2000 and July 2002, 95 patients with left main coronary artery stenosis >50% underwent coronary revascularization. Seventy-three unselected patients underwent OPCAB and 22 underwent revascularization using CPB. The techniques used for OPCAB included the use of deep traction sutures in the posterior pericardium and stabilizers to expose the distal coronary targets, Intraluminal coronary shunts were routinely used during construction of the anastomoses. Variables were analyzed using a Student's paired t-test with statistical significance defined as p < 0.05. Results: The mean age in the OPCAB group was 59.9 years and the CPB group 61.8 years (p = 0.54). There were 56 males (77%) in the OPCAB and 18 (82%) in the CPB groups. Mean preoperative left ventricular ejection fraction (LVEF) was 40.3% in OPCAB and 47.3% in CPB (p = 0.015). Average number of grafts was 3.1 in OPCAB and 4.1 in CPB (p = 0.0038). There were no conversions to CPB in those patients initially chosen to undergo OPCAB. There were no early deaths in OPCAB. There was one death in CPB. Mean hospital length of stay was 6.9 days for OPCAB and 9.1 for CPB (p = 0.0159). Conclusions: Patients with LMCD can undergo OPCAB grafting safely and effectively despite reduced LVEF. LMCD should no longer be seen as a contraindication to perform OPCAB grafting.

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