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Vijay Kohli
Mukesh Goel
Vijay Kumar Sharma
Yugal Mishra
Rajneesh Malhotra
Yatin Mehta
Naresh Trehan
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Asian Cardiovasc Thorac Ann 2003;11:285-288
© 2003 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTION

Off-Pump Surgery: a Choice in Unstable Angina

Vijay Kohli, MCh, Mukesh Goel, MCh, Vijay Kumar Sharma, MCh, Yugal Mishra, MD, Rajneesh Malhotra, MCh, Yatin Mehta, MD, Naresh Trehan, MD

Escorts Heart Institute and Research Centre, New Delhi, India

For reprint information contact: Vijay Kohli, MCh Tel: 91 11 6825000 Fax: 91 11 6825013 email: vijay_K22{at}yahoo.com Escorts Heart Institute & Research Centre, Okhla Road, New Delhi – 110 025, India.

The benefit and safety of off-pump coronary artery bypass surgery in patients with unstable angina was assessed retrospectively. From February 1996 to October 2001, 5,306 patients underwent multivessel off-pump coronary artery bypass, of whom 920 (17%) had unstable angina. In these 920 patients, ejection fractions ranged from 15% to 70%, 203 (22%) had an ejection fraction of 20%–35%, and 11 (1%) had an ejection fraction < 20%. Triple-vessel disease was present in 625 patients. Preoperative intraaortic balloon pump support was used in 28 patients. Operative approaches included mid sternotomy (86%), lower partial sternotomy (9%), and left anterior thoracotomy (2%). The number of grafts ranged from 1 to 5 with a mean of 2.43 ± 0.86, and 92.3% of patients received a left internal mammary artery graft. Twenty-two patients need intraoperative intraaortic balloon pumping. Ten patients (1%) suffered perioperative myocardial infarction. The mean hospital stay was 7.8 ± 4.3 days. Hospital mortality was 2/920 (0.22%). Intraaortic balloon pumping was helpful in these cases of unstable angina refractory to medical therapy. Off-pump coronary artery surgery was found to be safe and beneficial in these patients.






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