OPCAB for multiple arterial revascularization

  • J. F. Gummert
  • J.-F. Légaré
  • F. W. Mohr


The superiority of off-pump coronary artery bypass (OPCAB) versus on-pump coronary revascularization remains to be conclusively proven with only a few randomized studies performed with small groups of patients [1, 15, 18, 19]. However, a significant body of evidence, from large risk-adjusted retrospective studies, has suggested that coronary surgery performed without cardiopulmonary bypass (CPB) may reduce early mortality and major morbidity, such as, neurocognitive dysfunction, stroke, renal insufficiency and are the focus of previous chapters [10, 14). The present chapter will focus on complete arterial grafting in the setting of OPCAB.


Left Anterior Descend Saphenous Vein Graft Internal Thoracic Artery Arterial Grafting Arterial Revascularization 
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  1. 1.
    Ascione R, Angelini GD (2003) OPCAB surgery: a voyage of discovery back to the future. Eur Heart J 24(2):121–124PubMedCrossRefGoogle Scholar
  2. 2.
    Barner HB (1999) The continuing evolution of arterial conduits. Ann Thorac Surg 68(3 Suppl):S1–S8PubMedCrossRefGoogle Scholar
  3. 3.
    Bourassa MG, Fisher LD, Campeau L, Gillespie MJ, McConney M, Lesperance J (1985) Long-term fate of bypass grafts: the Coronary Artery Surgery Study (CASS) and Montreal Heart Institute experiences. Circulation 72(6 Pt 2):V71–V78PubMedGoogle Scholar
  4. 4.
    Calafiore AM, Contini M, Vitolla G et al (2000) Bilateral internal thoracic artery grafting: long-term clinical and angiographic results of in situ versus Y grafts. J Thorac Cardiovasc Surg 120(5): 990–996PubMedCrossRefGoogle Scholar
  5. 5.
    Cameron A, Davis KB, Green G, Schaff HV (1996) Coronary bypass surgery with internal-thoracic-artery grafts — effects on survival over a 15-year period. N Engl J Med 334(4):216–219PubMedCrossRefGoogle Scholar
  6. 6.
    Cohen G, Tamariz MG, Sever JY et al (2001) The radial artery versus the saphenous vein graft in contemporary CABG: a casematched study. Ann Thorac Surg 71(1):180–185PubMedCrossRefGoogle Scholar
  7. 7.
    Fitzgibbon GM, Kafka HP, Leach AJ, Keon WJ, Hooper GD, Burton JR (1996) Coronary bypass graft fate and patient outcome: angiographic follow-up of 5065 grafts related to survival and reoperation in 1,388 patients during 25 years. J Am Coll Cardiol 28(3): 616–626PubMedCrossRefGoogle Scholar
  8. 8.
    Gummert JF, Barten MJ, Hans C et al (2002) Mediastinitis and cardiac surgery — an updated risk factor analysis in 10373 consecutive adult patients. Thorac Cardiovasc Surg 50(2):87–91PubMedCrossRefGoogle Scholar
  9. 9.
    Hammon JW Jr, Stump DA, Kon ND et al (1997) Risk factors and solutions for the development of neurobehavioral changes after coronary artery bypass grafting. Ann Thorac Surg 63(6):1613–1618PubMedCrossRefGoogle Scholar
  10. 10.
    Hart JC, Puskas JD, Sabik JF III (2002) Off-pump coronary revascularization: current state of the art. Semin Thorac Cardiovasc Surg 14(1):70–81PubMedCrossRefGoogle Scholar
  11. 11.
    Kim KB, Kang CH, Chang WI et al (2002) Off-pump coronary artery bypass with complete avoidance of aortic manipulation. Ann Thorac Surg 74(4):S1377–S1382PubMedCrossRefGoogle Scholar
  12. 12.
    Kim KB, Lim C, Lee C et al (2001) Off-pump coronary artery bypass may decrease the patency of saphenous vein grafts. Ann Thorac Surg 72(3):S1033–S1037PubMedCrossRefGoogle Scholar
  13. 13.
    Lytle BW, Blackstone EH, Loop FD et al (1999) Two internal thoracic artery grafts are better than one. J Thorac Cardiovasc Surg 117(5):855–872PubMedCrossRefGoogle Scholar
  14. 14.
    Magee MJ, Jablonski KA, Stamou SC et al (2002) Elimination of cardiopulmonary bypass improves early survival for multivessel coronary artery bypass patients. Ann Thorac Surg 73(4):1196–1202PubMedCrossRefGoogle Scholar
  15. 15.
    Nathoe HM, van Dijk D, Jansen EW et al (2003) A comparison of on-pump and off-pump coronary bypass surgery in low-risk patients. N Engl J Med 348(5):394–402PubMedCrossRefGoogle Scholar
  16. 16.
    Tector AJ, McDonald ML, Kress DC, Downey FX, Schmahl TM (2001) Purely internal thoracic artery grafts: outcomes. Ann Thorac Surg 72(2):450–455PubMedCrossRefGoogle Scholar
  17. 17.
    Tran HM, Paterson HS, Meldrum-Hanna W, Chard RB (1998) Tunnelling versus open harvest technique in obtaining venous conduits for coronary bypass surgery. Eur J Cardiothorac Surg 14(6): 602–606PubMedCrossRefGoogle Scholar
  18. 18.
    van Dijk D, de Jaegere PP (2002) Neuropsychological outcome after off-pump versus on-pump coronary bypass surgery: the octopus randomized trial. Circulation 105(21):E179PubMedCrossRefGoogle Scholar
  19. 19.
    van Dijk D, Nierich AP, Jansen EW et al (2001) Early outcome after off-pump versus on-pump coronary bypass surgery: results from a randomized study. Circulation 104(15):1761–1766PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • J. F. Gummert
  • J.-F. Légaré
  • F. W. Mohr

There are no affiliations available

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