Chirag Doshi1, Manish Hinduja2, Vivek Wadhawa3, Gaurag Shah4, Malkesh Tarsaria5, Bhavin Brahmbhatt6, Shaival Majumdar7, Sumbul Siddiqui8
Coronary Artery Bypass Grafting (CABG) is one of the most frequently done cardiac surgical procedures. However, with the advancements in catheter-based interventional procedures, the category of patients taken up for CABG is gradually being restricted to more high-risk group. Additional surgical procedures like Coronary Endarterectomy (CE) are needed for treating such high-risk coronary artery disease to achieve complete revascularisation. Off-pump coronary endarterectomy can be performed safely with morbidity and mortality comparable with those of conventional coronary endarterectomy.
MATERIALS AND METHODS
This is a single institutional retrospective study with 480 patients underwent concomitant off-pump CE and CABG. Average number of coronary bypass grafts were 2.4±0.8. There were 321 cases of LAD endarterectomy with 246 receiving LIMA as the arterial graft. 2.9% patients were converted to on-pump surgery intraoperatively because of intraoperative hypotension.
The incidence of postoperative MI was 0.8%. The 30-day mortality was 0.8% from complications of bowel ischaemia and three patients with septicaemia associated with prolonged intubation. The mean operating time was 118±22 minutes.
We have shown that the effect of OPCABG with CE appears to be safe and early outcomes are encouraging. Hence, diffuse disease requiring endarterectomy should not be considered a contraindication to OPCABG. Surgical skills and the suitability criteria of the patients are very important in this regard.