Portal de Periódicos da CAPES

Off-Pump Total Arterial Revascularization:. Our Experience

2004; Wiley; Volume: 19; Issue: 5 Linguagem: Inglês

10.1111/j.0886-0440.2004.04078.x

1540-8191

Rubén Tarrío, J.J Cuenca, Valdemar Marques Gomes, Vicente Campos, José María Herrera, Fernando Rodríguez‐Rodríguez, José Vicente González Valle, Francisco Portela, Javier García-Carro, Belén Adrio, Francisco Vega, Alberto Juffé,

Coronary Interventions and Diagnostics

Off-pump coronary artery bypass grafting with both the internal thoracic arteries, such as the Tector technique, can reduce the morbidity associated with extracorporeal circulation and aortic cross-clamp. The aim of the present study is to describe our experience and the results obtained.From April 1998 to December 2003, the off-pump Tector technique was performed on 743 patients, of whom 621 were male (83.5%), with a mean age of 65.3 +/- 9.5 years (23-90). Preoperative risk factors were diabetes mellitus in 29.5% and peripheral vasculopathy in 14.7% of the patients. Angiography showed left main disease in 25.6% and triple-vessel disease in 50.3% of the patients, with a mean ejection fraction of 60%+/- 13% (23-88). Both the internal thoracic arteries were harvested using the skeletonization technique and were anastomosed as "Y" or "T" grafts. Intraoperative graft patency was checked using a Doppler flowmeter.A total of 2028 distal anastomoses were performed, the average being 2.7 (1 to 5) per patient. At least three distal anastomoses were undertaken in 62% of the patients. Postoperative complications included atrial fibrillation in 40 patients (5.4%), myocardial infarction in 24 (3.2%), mediastinitis and reoperation for bleeding in 7 (0.9%) and stroke in 3 (0.4%). Twenty-four patients (3.2%) died in the first month postoperatively.The off-pump Tector technique appears to be safe, showing a low surgical morbidity.