Coronary artery bypass surgery without cardiopulmonary bypass |
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| Institution: | 1. Department of Dermatooncology, Hotel Dieu Nantes University Hospital, Nantes, France;2. Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia;3. Queensland Melanoma Project, Discipline of Surgery, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, QLD, Australia;4. Melanoma Sarcoma Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;5. Service d''Oncologie Médicale, Hôpital François Mitterrand, Pau, France;6. Skin Cancer Center Hannover, Department of Dermatology, Hannover Medical School, Hannover, Germany;7. Petrov Research Institute of Oncology, St Petersburg, Russia;8. Department of Soft Tissue, Bone Sarcoma, and Melanoma, Maria Sklodowska-Curie Institute, Oncology Center, Warsaw, Poland;9. Department of Dermatology and Skin Cancers, La Timone APHM Hospital, Aix-Marseille University, Marseille, France;10. Department of Skin and Soft Tissue Tumours, National Cancer Institute, Kiev, Ukraine;11. Swissmed Centrum Zdrowia, Gdansk, Poland;12. Department of Surgical Oncology, Gdansk Medical University, Gdansk, Poland;13. Dermatology Department, Hôpital Robert Debré, Université de Reims Champagne-Ardenne, Reims, France;14. Department of Dermatology, Centre Hospitalier Universitaire, Tours, France;15. UFR de Médecine, Université François-Rabelais, Tours, France;p. Melanoma Immunology and Oncology Group, Centenary Institute, University of Sydney, Sydney, NSW, Australia;q. Melanoma Institute Australia, Sydney, NSW, Australia;r. Dermato-oncology Department, General University Hospital, Prague, Czech Republic;s. Columbus Clinic Center, Milan, Italy;t. Division of Hematology & Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA;u. Département de Dermatologie, Centre Hospitalier Universitaire, Hôpital Saint-Éloi, Montpellier, France;v. Department of Medical Oncology, Erasmus MC Cancer institute, Rotterdam, Netherlands;w. Cancer Research Center, Moscow, Russia;x. Seattle Cancer Care Alliance, University of Washington, Seattle, WA, USA;y. Department of Oncology and Medical Radiology, Dnipropetrovsk State Medical Academy, Dnipropetrovsk, Ukraine;z. Centrum Medyczne Bieńkowski, Klinika Chirurgii Plastycznej, Bydgoszcz, Poland;11. Department of Oncological Surgery, Oncology Center, Bydgoszcz, Poland;12. Melanoma Unit, Dermatology Department, Hospital Clinic of Barcelona, Institut d''Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain;13. Centro de Investigación Biomédica en Red de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain;14. Instituto de Oncología Ángel H Roffo, Universidad de Buenos Aires, Buenos Aires, Argentina;15. Department of Dermatology, Venereology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany;16. Medical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands;17. GlaxoSmithKline, Rixensart, Belgium;18. Immunology Translational Medicine, UCB, Brussels, Belgium;19. Biostatistics Department, Janssen Research & Development, Beerse, Belgium;110. ViaNova Biosciences, Brussels, Belgium;111. Laboratoires Servier, Paris, France;112. University Hospitals Leuven, Leuven, Belgium;113. UPMC Hillman Cancer Center, Pittsburgh, PA, USA |
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| Abstract: | In the years 1994 and 1995, 1087 patients underwent coronary artery bypass grafting at our institution. Of these, 297 were operated on without cardiopulmonary bypass. 239 were male, and 58 were female. Their ages ranged from 28 to 81 years (54.43 ± 9.63). Of the total, 294 were operated on electively, two as a coronary reoperations, and one as an emergency after a failed percutaneous transluminal coronary angioplasty procedure. In all patients complete revascularization was the aim, and a cardiopulmonary bypass team was kept on standby. Median sternotomy was performed as the exposure in all patients, except a patient who underwent a coronary reoperation through a left thoracotomy incision. The average of the distal anastomoses was 1.51 ± 0.6, ranging from 1 to 3. The left internal thoracic artery was used in 292 operations, which was an individual graft in 284, a sequential graft in five, and a free graft in four. Major complications in the early postoperative period were noted in three patients as reoperation for excessive bleeding. One patient had reoperation for left internal thoracic artery spasm, and one patient had lower extremity ischemia caused by intraoartic balloon counterpulsation. Hospital mortality was 0.3% with one patient. It is our belief that in selected cases coronary artery bypass grafting without cardiopulmonary bypass is a safe procedure with the advantage of improvement in recovery during the postoperative period. |
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