Off-pump myocardial revascularization using the octopus tissue stabilizer system

Off-pump coronary artery bypass surgery (OPCAB) has changed the approach to contemporary coronary surgery. Development of new surgical devices and techniques has reduced morbidity and mortality during off-pump surgery. From March 2000 - April 2002, a total of 136 patients underwent open heart surgery using off-pump technique and fast-track anesthesia at Dedinje Cardiovascular Institute. Octopus Medtronic coronary stabilizer was used for stabilization of targeted vessel. Arterial grafts were used 169 times and saphenous vein 69 times. Average number of anastomoses was 1,830,73 per patient. One patient (0.74%) died. Three patients (2.21%) underwent surgery revision due to postoperative bleeding and one (0.74%) because of graft dysfunction Perioperative myocardial infarction was registered 2 times (1.47%) pneumothorax 3 times (2.21%), postoperative arrhythmias 11 times (8.09%) transitory ischemic attack once (0.74%) and deep wound infection once (0.74%). Twelve patients (8.82%) required prolonged inotropic support Angiographies early revealed patent grafts in 8 patients (5.88%). OPCAB is a safe and effective alternative approach to coronary artery revascularization Use of coronary stabilizer has improved the safety and quality of OPCAB surgery.

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Off-Pump Coronary Artery Bypass Surgery May Produce a Hypercoagulable Patient

The Heart Surgery Forum ◽

10.1532/hsf.698 ◽

2005 ◽

Vol 6 (2) ◽

pp. 94 ◽

Cited By ~ 23

Author(s):

Robert L. Quigley ◽

David W. Fried ◽

John Pym ◽

Richard Y. Highbloom

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Heart Surgery ◽

Artery Bypass ◽

Open Heart Surgery ◽

Anticoagulation Therapy ◽

Maximum Amplitude ◽

Platelet Activity ◽

Off Pump ◽

Pump Coronary Artery Bypass

Background: The incidence of thromboembolic events following traditional open heart surgery has not been clinically significant. However, with beating heart surgery, for which cardiopulmonary bypass (CPB) is not required, the incidence of spontaneous intravascular thrombosis may be similar to that encountered after general surgeries. Compounding this risk is that many cases of off-pump coronary artery bypass (OPCAB) surgery are reserved for the elderly patient with multiple comorbidities. The few studies to date that have assessed the coagulation profile in OPCAB patients have been limited to the first 24 hours after surgery. Methods: We prospectively studied 17 OPCAB and 6 on-pump patients over 4 days (hospital course) with daily thromboelastography. A coagulation index (CI) (reflecting R and K times, a angle, and maximum amplitude [MA]) was calculated for the patients, who served as their own controls. Results: The OPCAB patients demonstrated 3 days postoperatively a 17% increase in coagulation compared with the baseline. Specifically, the CI consistently revealed an elevation in the a angle and the MA, both of which reflect increased fibrinogen and platelet activity. On the other hand, 3 days following surgery the CI of the CPB group was tightly clustered around their respective baseline CI values, which had recovered from a significant decrease immediately after surgery. Conclusion: A state of hypercoagulability, as measured by thromboelastography, exists in the OPCAB patient beyond the first postoperative day, and this finding suggests that prophylactic postoperative anticoagulation therapy targeting fibrinogen and platelet activity may be indicated for these patients.

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Heart Surgery in a Male Patient with Blood Group OH (Bombay Phenotype) - A Rare Case Report

University Heart Journal ◽

10.3329/uhj.v6i2.7258 ◽

1970 ◽

Vol 6 (2) ◽

pp. 110-113

Author(s):

Md Mazibur Rahman ◽

Sheikh Muhammad Shaheedul Islam ◽

Md Sirajul Islam ◽

Ayesha Khatun ◽

Jala Uddin ◽

...

Keyword(s):

Coronary Artery ◽

Blood Group ◽

Heart Surgery ◽

Artery Bypass ◽

Autologous Blood ◽

Myocardial Revascularization ◽

Postoperative Recovery ◽

Off Pump ◽

Rare Case Report ◽

Pump Coronary Artery Bypass

A 59 years old gentleman with hypertension, type-2 DM, dyslipidemia and atheroschlerotic stenosing coronary artery disease had the rare blood group Oh ((Bombay phenotype). After prophylactic conservation of two units of predeposit autologous blood, myocardial revascularization was successfully accomplished with off pump coronary artery bypass surgery (OPCAB). Postoperative recovery was uneventful.Key words: Bombay phenotype; OPCAB DOI: 10.3329/uhj.v6i2.7258University Heart Journal Vol. 6, No. 2, July 2010 pp.110-113

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Coronary Endarterectomy with off Pump Coronary Artery Bypass Surgery- A Review

Cardiovascular Journal ◽

10.3329/cardio.v10i1.34368 ◽

2017 ◽

Vol 10 (1) ◽

pp. 84-90

Author(s):

Redoy Ranjan ◽

Dipannita Adhikary ◽

Heemel Saha ◽

Sanjoy Kumar Saha ◽

Sabita Mandal ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Myocardial Revascularization ◽

Graft Patency ◽

Coronary Endarterectomy ◽

Off Pump ◽

Diffuse Coronary Artery Disease ◽

Artery Disease ◽

Pump Coronary Artery Bypass

Coronary endarterectomy is first described as an alternative surgical procedure for myocardial revascularization against diffuse coronary artery disease by Baily et al. in 1956. Coronary endarterectomy provides complete surgical revascularization of the myocardium in diffuse and calcified coronary arteries with adequate blood flow to distal part of occluded arteries, thus improving ventricular function. However, the initial outcomes of coronary endarterectomy were not satisfactory but now-a-days different studies have shown that coronary endarterectomy with coronary artery bypass grafting can be done safely with acceptable morbidity and mortality. Moreover, the graft patency rate on angiographic evaluation is also good following coronary endarterectomy. So, its time to reevaluate this old techniques, and reanalysis the current outcomes of coronary endarterectomy and readdress its indication in diffuse coronary artery diseaseCardiovasc. j. 2017; 10(1): 84-90

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Effects of preoperative antiplatelet therapy on postoperative bleeding using thromboelastography in off-pump coronary artery bypass grafting

European Journal of Anaesthesiology ◽

10.1097/00003643-200605001-00095 ◽

2006 ◽

Vol 23 (Supplement 38) ◽

pp. 33

Author(s):

H. J. Kwak ◽

J. Y. Kim ◽

W. S. Jung ◽

Y. W. Hong ◽

Y. L. Kwak

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Antiplatelet Therapy ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Postoperative Bleeding ◽

Bypass Grafting ◽

Artery Bypass Grafting ◽

Off Pump ◽

Pump Coronary Artery Bypass

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TCT-172: Comparison of Same Sitting, Robotic Assisted Hybrid Coronary Artery Revascularization with Off-Pump Coronary Artery Bypass Surgery in Multi-vessel Coronary Artery Disease

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2010.08.194 ◽

2010 ◽

Vol 56 (13) ◽

pp. B40-B41

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Robotic Assisted ◽

Off Pump ◽

Coronary Artery Revascularization ◽

Artery Disease ◽

Pump Coronary Artery Bypass ◽

Vessel Coronary Artery

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Off-pump coronary artery bypass grafting using arterial grafts exclusively: aiming for an absolute “no-touch” aortic technique

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(03)01044-0 ◽

2004 ◽

Vol 77 (1) ◽

pp. 379-380 ◽

Cited By ~ 2

Author(s):

Olivier Chavanon ◽

Mohamed Abdennadher ◽

Dominique Blin

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Arterial Grafts ◽

Artery Bypass Grafting ◽

Off Pump ◽

Pump Coronary Artery Bypass

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158 Effect of Preoperative Continuation of Aspirin on Postoperative Bleeding After Off-Pump Coronary Artery Bypass Grafting (OPCABG)

British Journal of Surgery ◽

10.1093/bjs/znab259.233 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

M I S Al-Manzo ◽

S Biswas ◽

S Das Gupta ◽

Md.Z Rahman ◽

B Basak ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Chest Tube ◽

Artery Bypass ◽

Postoperative Bleeding ◽

Bypass Grafting ◽

Off Pump ◽

Significant Difference ◽

Pump Coronary Artery Bypass

Abstract Background Despite ample evidence of continued preoperative aspirin to improve outcomes in coronary artery bypass surgery, practice for routine continued preoperative aspirin use is still inconsistent due to concern for increased postoperative bleeding. The purpose of this study was to investigate preoperative aspirin use and its effect on postoperative bleeding after off-pump coronary artery bypass grafting (OPCABG). Method This cohort study involved patients (n = 74) who underwent OPCABG at a single center between August 2017 to January 2018. After considering the inclusion and exclusion criteria, they were divided into two groups: one (n = 37) received tablet Aspirin 75mg till the day of surgery and for the other group (n = 37) aspirin was stopped 5 days before surgery. Postoperative bleeding was recorded in both groups. After considering preoperative, intraoperative, and postoperative variables statistical analysis was done. Results There was no significant difference between the two groups concerning preoperative and peroperative variables. No significant difference was also observed between the two groups in chest tube drainage at 1sthour, 2ndhour, 3rdhour, 24thhour, next 24 hours (at 48th hour), and next 24 hours (at 72nd hour) (p = 0.845, 0.126, 0.568, 0.478, 0.342 and 0.717 respectively). No significant difference was seen in the transfusion requirement of blood and fresh frozen plasma (FFP). Conclusions Continuation of preoperative aspirin till the day of surgery is not associated with an increase in chest tube drainage, re-operation for bleeding complications, or transfusion of blood and FFP.

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