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Coronary Artery Bypass Surgery Without Cardioplegia: Early Results

Department of Cardiothoracic Surgery Sultanah Aminah Hospital Johor Bahru, Johor, Malaysia

For reprint information contact: Wong Poo Sing, FRCS(CTh) Tel: 60 7 223 1666 Ext. 2130/2132 Fax: 60 7 221 3376 email: poosing{at}pc.jaring.my Department of Cardiothoracic Surgery, Sultanah Aminah Hospital, Jalan Skudai, Johor Bahru, Johor 80100, Malaysia.

From November 1996 to April 1999, 348 patients underwent isolated non-cardioplegic coronary artery bypass grafting at a new center. There were 123 (35%) patients aged over 60 years, 48 (14%) were female, 70 (20%) had a left ventricular ejection fraction below 0.3. Coronary artery bypass graft surgery was performed using hypothermic intermittent ischemic fibrillatory arrest of the heart. The left internal mammary artery was used in 97% of cases. Mean grafts per patient was 3.5. Sixty-three patients (18%) underwent 65 coronary endarterectomies. The overall operative mortality rate was 2.3% (8/348). Follow-up was 97% complete. Mean follow-up was 14.9 ± 8 months (range, 1 to 30 months). Freedom from angina was 98.3% at 6 months, 97% at 12 months, and 97% at 24 months. The overall survival was 96.7% at 6 months, 95.8% at 12 months, and 94.4% at 24 months. It was concluded that this method of myocardial protection for isolated coronary artery bypass graft surgery provided excellent operating conditions in this group of patients.