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Coronary Artery Bypass Grafting Without Cardiopulmonary Bypass

Tevfik Tezcaner, MD, Cem Yorganciolu, MD, Zeki Çatav, MD, Ouz Moldibi, MD, Hilmi Tokmakolu, MD, Kaya Süzer, MD, Yaman Zorlutuna, MD

Thoracic and Cardiovascular Surgery Clinic Bayindir Medical Center Ankara, Turkey

For reprint information contact: Tevfik Tezcaner, MD Tel: 90 312 438 1709 Fax: 90 352 437 5285 Reat Nuri Sokak 86/16, Yukari Ayranci, Ankara 06540, Turkey.

Between March 1994 and April 1998, 2869 patients underwent coronary artery bypass grafting at our institution. Of these, 415 (14.5%) with a mean age of 54.4 ± 9.9 years were operated on without cardiopulmonary bypass. Internal thoracic artery was used in 402 cases (97%) and the left anterior descending artery was revascularized in all except 1. Distal anastomoses ranged from 1 to 3, with a mean of 1.45 ± 0.58. Major postoperative complications comprised reoperation because of internal thoracic artery spasm in 1 patient, lower extremity ischemia due to intraaortic balloon pumping in 1 patient, revision for excessive bleeding in 3, and perioperative myocardial infarction in another 3. Hospital mortality was 1.2% (5 deaths). Coronary angiography was performed in 38 patients, 1 to 44 months postoperatively. Examination of 56 distal anastomoses revealed a patency rate of 86.1% for internal thoracic artery grafts and 55% for saphenous vein grafts. It was concluded that coronary bypass surgery without cardiopulmonary bypass gave favorable results in the early postoperative period. However, considering the late graft patency rates, either patient selection or the technique should be reevaluated.