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Gopichand Mannam
Lokeswara R Sajja
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Asian Cardiovasc Thorac Ann 2008;16:473-478
© 2008 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Off-Pump Coronary Revascularization for Left Main Coronary Artery Stenosis

Gopichand Mannam, FRCS(CT), Lokeswara R Sajja, MCh, Satya BR Dandu, MCh, Satyendra N Pathuri, MCh, Krishnamurthy VSS Saikiran, MCh, Sriramulu Sompalli, MD1

Division of Cardiothoracic Surgery
1 Division of Cardiac Anesthesiology, CARE Hospital, The Institute of Medical Sciences, Hyderabad, India

For reprint information contact: Lokeswara R Sajja, MCh Tel: 91 40 6666 1935 Fax: 91 40 2332 7025 Email: sajjalr{at}yahoo.com, Division of Cardiothoracic Surgery, CARE Hospital, The Institute of Medical Sciences, Road No.1, Banjara Hills, Hyderabad-500034, India.

Experience of on- and off-pump coronary artery bypass in 379 patients with significant left main coronary artery stenosis was retrospectively reviewed. Beating-heart operations were performed on 219 patients between January 2001 and October 2007. Their results were compared with 160 who underwent revascularization under cardiopulmonary bypass during the same period. All patients had multivessel grafting via a median sternotomy. Both groups were comparable demographically. Off-pump patients received significantly fewer grafts per patient (3.21 ± 0.86 vs 3.74 ± 0.82). The use of moderate or high doses of inotropics (> 5 µ g · kg–1 · min–1) was more frequent in the on-pump group (44% vs 26%). Postoperative blood transfusion requirement was lower in off-pump patients, and fewer of them experienced worsening of preexisting renal insufficiency. There were 2 operative deaths in the on-pump group and 1 in the off-pump group. The off-pump procedure is safe and effective in patients with left main coronary artery disease.






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