Introduction : If a small number of distal anastomoses is required, off-pump CABG has become the intervention of choice. The aim of this study is to determine the feasibility and safety of OPCAB surgery in patients demanding multiple distal anastomoses.
Methods : From January 2002 to September 2004, 232 patients received OPCAB surgery. Group A included 130 patients with one or two distal anastomoses only, and group B included 102 patients with more than two anastomoses. There were no significant preoperative differences between groups in gender, age, Euroscore, redo surgery, ejection fraction or diabetes mellitus. Haemodialysis was statistically significant more prevalent in group A. Intraluminal shunts were used in all patients.
Results: In group A, 1.79 ± 0.41 distal anastomoses were performed, whereas 3.17 ± 0.42 in group B. There were no conversions in group A and five in group B (Chi square = 0.025), due to impending hemodynamic collapse (3), ventricular arrhythmia (1) and supraventricular arrhythmia (1). For both groups postoperative evolution was similar without statistical difference in intubation time, total blood loss, transfusion requirement, ICU or hospital stay. Evaluation of the postoperative peak troponine or CK-MB value revealed no statistical difference. The in hospital mortality for group A was 4 (3.0%) and 1 (1.0%) in group B (ns).
Conclusion : Compared with small number of distal anastomoses, multiple vessel beating heart surgery can be performed with an equal postoperative course and without enhanced risk of myocardial damage.