Revista chilena de cirugía
versión On-line ISSN 0718-4026
SEGUEL S, ENRIQUE et al. On-pump beating heart coronary artery bypass grafting surgery for high risk patients. Rev Chil Cir [online]. 2011, vol.63, n.1, pp.15-20. ISSN 0718-4026. http://dx.doi.org/10.4067/S0718-40262011000100003.
Background: The technique for coronary surgery involves the use of extra corporeal circulation (On-pump) and cardioplegia. In high-risk patients this surgery has high morbidity and high mortality. Surgery On-pump beating heart is an alternative for those cases. We describe our experience with this technique. Patients and Methods: 11 patients were operated between 2007 and 2008. Ten men (mean 59.5 years). Four patients with evolving myocardial infarction, 2 patients with left main coronary artery lesion and all with three-vessel lesion. Ejection fraction (EF) averaged was 31.5%. Four surgeries were considered urgent. Results: All procedures were completed with the technique, 3.1 by pass were performed per patient and all received an internal mammary artery. Mechanical ventilation averaged 13.6 hours. Removal of IABP between first and second day. Stay in ICU 4.82 days. There were no perioperative infarctions or stroke. One patient had renal failure. Postoperative hospital stay was 10.6 days. Postoperative echocardiogram (2 months) showed an average EF of 38.3% (NS). Conclusions: In this series, high-risk coronary patients were operated On-pump beating heart. This technique allowed complete revascularization, good immediate outcome and ventricular function improved in the medium term.
Palabras clave : Coronary artery disease; myocardial revascularization; coronary artery bypass; cardiopulmonary bypass; beating heart coronary artery bypass.