Minimally invasive coronary artery bypass surgery

Abstract

In the hope of decreasing patient trauma and morbidity, cardiothoracic surgeons at the Ochsner Clinic are currently investigating techniques of performing coronary bypass surgery without the use of the cardiopulmonary bypass machine, which can cause complications following surgery in patients with certain coexisting conditions (such as renovascular, cerebrovascular, or pulmonary disease), particularly elderly patients. The initial 15 at-risk patients who underwent off-pump coronary artery bypass have demonstrated extremely encouraging results in reducing previously expected complication rates. Operative and intermediate survival was 100%. Eighty percent (80%) of procedures were accomplished without red blood cell transfusion, 100% were extubated within 24 hours of surgery, and (with the exception of two out-layers who had prolonged stays due to non-cardiac causes) the average length of stay was 5 days with only 18% demonstrating postoperative atrial arrhythmia. We are evaluating our technique to conform to multicenter protocols in the hope of identifying precisely which groups of patients will receive the maximal benefit from this procedure.

Figure 1.

Retraction sutures allow access to the heart

Figure 2.

Off-pump coronary artery bypass procedure

Dr. Van Meter is the Head of Ochsner's Section on Cardiothoracic Surgery