Multiple Arterial Off-Pump Coronary Artery Bypass Grafting: A 5-Year Experience with Clinical Results

  • Bojan Biocina
  • Zeljko Sutlic
  • Igor Rudez
  • Davor Baric
  • Daniel Unic
  • Bojan Stambuk


Background: The use of arterial grafts combined with the off-pump coronary artery bypass (OPCAB) procedure offers many advantages, but most of them are still to be proven in long-term studies. We present our 5-year experience in combining these 2 strategies in coronary surgery.

Methods: From February 1998 to December 2002 we operated on 155 patients (146 men and 9 women) for multiple arterial graft myocardial revascularization. All procedures were performed as OPCAB grafting using internal mammary and radial arteries. The mean ± SD was 58 ± 9 years for patient age, 57% ± 11% for left ventricle ejection fraction, and 2.3 ± 1.9 for the EuroSCORE. We reviewed perioperative and postoperative data and in-hospital mortality in our patients.

Results: A total of 356 distal anastomoses were created, an average of 2.3 per patient. The left internal mammary artery was used as a graft in 153 patients (98%), the right internal mammary artery was used in 13 patients (8%), and the radial artery was used in 146 patients (94%). No venous grafts were used. There were 4 reopenings (2.6%) because of mediastinal bleeding. Four patients (2.6%) experienced perioperative myocardial infarction, and 2 patients (1.3%) had permanent neurologic dysfunction. Five patients (3.2%) died in the hospital within 30 days of the operation.

Conclusion: Our experience shows that arterial myocardial revascularization can be safely performed as an OPCAB procedure, even in the treatment of multiple-vessel coronary disease. The long-term benefit for patients is to be evaluated in the future.


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How to Cite
Biocina, B., Sutlic, Z., Rudez, I., Baric, D., Unic, D., & Stambuk, B. (2005). Multiple Arterial Off-Pump Coronary Artery Bypass Grafting: A 5-Year Experience with Clinical Results. The Heart Surgery Forum, 6(3), 132-134.

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