Can surgeons do complete revascularization in diabetic patients using the off-pump technique?

Background: : The arguments are discussed as to whether or not to proceed with multivessel percutaneous coronary intervention, with or without a drug-eluting stent, in patients with diabetes mellitus (DM), including (1) surgeons unable to complete revascularization because of smaller native arteries; and (2) diabetic patients being sicker and having higher operative mortality rates than nondiabetic patients (non-DM), particularly with the conventional coronary artery bypass surgery (on-pump) technique. To support or dispute the claims, a retrospective review of 480 consecutive patients at a single institution (195 DM and 285 non-DM) was carried out. Observations were made to see whether diabetes is a predictor of poor outcomes.

Technique of using the St. Jude aortic connector with the radial artery.

We present a technique for the use of St. Jude Aortic Connector System with the radial artery. This technique will allow surgeons, who prefer the radial artery to the vein, to use this approach whenever feasible.

Off-pump coronary artery bypass surgery: evaluation of extubation time and predictors of failed early extubation.

Anesthesia during and after off-pump surgery is critical for the outcome of the procedure. Intubation time has been shown to correlate with ICU time and length of stay. This study is to evaluate the extubation time and predictors of prolonged extubation in this institution.

The use of gastroepiploic artery for coronary artery bypass surgery.

The use of arterial conduits in surgical treatment of coronary heart disease has been widely used. As we all know that saphenous vein graft occluded more than 50 per cent after 10 years. Most arterial conduits come from internal mammary artery, radial artery than been used for decades.

Off-pump coronary bypass surgery and all arterial conduits: learning experience at Bangkok Heart Institute.

Off-pump coronary artery bypass technique or bypass graft surgery without the use of a heart-lung machine has been introduced in the last six years, and now comprises approximately 25 per cent of all coronary artery bypass surgery being done in the world. One of the goals of beating heart surgery is to eliminate the complications associated with the use of cardiopulmonary bypass. The use of all arterial conduits for coronary artery bypass graft has become more acceptable after experiences gained and reports of better long-term results.