Off-pump, total arterial coronary artery bypass grafting (CABG) is a technically demanding myocardial revascularization strategy that combines the long-term benefits of multi-arterial CABG with a no-touch aortic technique. Dedicated training and mentoring are essential in order to learn how to successfully perform this challenging surgical procedure. In this video-tutorial, we present a complete step-by-step approach to safely reproduce this procedure. We will cover the harvesting techniques adopted for internal mammary arteries (ITAs) and for the radial artery (RA), and the several options to construct and deploy multi-arterial composite grafts ("T/Y", "K", and "I" grafts), with a focus on minimizing aortic manipulation.
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| http://dx.doi.org/10.1510/mmcts.2020.003 | DOI Listing |
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Heparin rebound in patients undergoing off-pump coronary artery bypass grafting surgery: a single-center retrospective study.
J Cardiothorac Surg
January 2025
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 167, Beilishi Road, Xicheng District, China.
Background: Heparin, an anticoagulant used in cardiac surgery, can result in heparin rebound (HR), where it returns postoperatively despite being neutralized with protamine. This study was designed to investigate the prevalence of HR in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and evaluate the impact of HR on their short-term outcomes.
Methods: HR was defined by a 10% increase in activated coagulation time (ACT) following two hours of heparin neutralization with protamine, bleeding over 200 mL/h, and abnormal laboratory coagulation examination results.
The Effects of Seasonal Variation on the Outcomes of Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.
Rev Cardiovasc Med
December 2024
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100037 Beijing, China.
Background: The impact of seasonal patterns on the mortality and morbidity of surgical patients with cardiovascular diseases has gained increasing attention in recent years. However, whether this seasonal variation extends to cardiovascular surgery outcomes remains unknown. This study sought to evaluate the effects of seasonal variation on the short-term outcomes of patients undergoing off-pump coronary artery bypass grafting (OPCABG).
View Article and Find Full Text PDFEarly Postoperative Outcome of Continuous Heparin Infusion versus Intermittent Intravenous Heparin after Initial Bolus Dose during Off-Pump Coronary Artery Bypass Surgery: An Eminent Time worthy Study.
Mymensingh Med J
January 2025
Dr Khondokar Shamim Shahriar Ziban Rushel, Assistant Professor, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh; E-mail:
Heparin is an anticoagulant used invariably in all cardiac surgery. Heparin dosing and its reversal were determined by monitoring activated clotting time (ACT). Intermittent heparin dosing after initial bolus dose is widely practiced to maintain ACT level 200-300 seconds in Off-pump coronary artery bypass surgery (OPCAB).
View Article and Find Full Text PDFFemales are Associated with Lower Risks of Long-Term Mortality in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.
Arq Bras Cardiol
November 2024
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing - China.
Background: In patients who underwent off-pump coronary artery bypass grafting (OPCABG), females were reported to have lower rates of in-hospital mortality rate and postoperative atrial fibrillation than males. However, the association between gender and long-term prognosis following OPCABG is rarely reported.
Objective: This study aims to determine if women benefit more from OPCABG than men by comparing the difference in the risk of long-term all-cause mortality in patients with coronary chronic total occlusion (CTO).
Minimally invasive coronary artery bypass grafting using the skeletonized right gastroepiploic artery.
JTCVS Tech
December 2024
Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan.
Article Synopsis
- The study evaluated the clinical outcomes of using the right gastroepiploic artery in minimally invasive coronary artery bypass grafting procedures.
- A total of 428 patients were analyzed, with the right gastroepiploic artery used in 18.2% of cases, leading to a high rate of successful revascularization (93.6% total, 98.7% complete).
- Postoperative results revealed no in-hospital deaths, a low incidence of new atrial fibrillation (9%), and a manageable median ICU stay of 2 days, indicating favorable outcomes with this surgical approach.
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