Off-Pump Coronary Artery Bypass Grafting

Lee, Young Tak

Abstract

Coronary artery revascularization with arterial graft is believed to have superiority to that with vein graft with a long-term survival rate with its superb of patency rate. Furthermore, the bilateral internal thoracic artery grafting is an independent predictor of lower rates of angina recurrence, late myocardial infarction, and late cardiac events including reoperation or reintervention. Off-pump coronary artery bypass grafting (OPCAB), which means surgery under the beating heart without use of cardiopulmonary bypass (CPB), is a new attractive surgical strategy for coronary artery disease, because of its benefits for the patients with porcelain ascending aorta to prevent of cerebral emboli and comorbidities such as renal failure, cerebral event, right ventricle dysfunction, and pulmonary disease. The minimally invasive coronary bypass grafting, which means lesser incision, surgery without CPB, and early recovery, can be the surgical method of choice for single vessel disease or limited double vessel disease, with its advantages of early return to work and cosmetics. The OPCAB has been increasing steadily in Korea since 1996, comprising almost 900 cases among the 2,600 cases of bypass surgery performed in the whole country in 2001. The overall mortality rate of bypass surgery in Korea was near 2.3%, comparable to that in western countries. Conclusively, the surgical revascularization for coronary artery disease has the advantages of reducing the cost and lowering the cardiac event, such as reoperation or reintervention.