Importance of anastomotic sequencing during off-pump coronary artery bypass surgery: a pilot strategy

Kaya K., Mungan U.

Lokman Hekim Health Sciences, cilt.2, sa.3, ss.5-10, 2022 (Hakemli Dergi)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 2 Sayı: 3
  • Basım Tarihi: 2022
  • Doi Numarası: 10.14744/lhhs.2022.60004
  • Dergi Adı: Lokman Hekim Health Sciences
  • Derginin Tarandığı İndeksler: EBSCO Education Source
  • Sayfa Sayıları: ss.5-10
  • Lokman Hekim Üniversitesi Adresli: Evet

Özet

Introduction
Off-pump coronary artery surgery is a method preferred by many surgeons today to avoid the adverse effects of cardiopulmonary bypass. Although this method was quite popular at first but was later abandoned by some surgeons due to unfavorable results. We think the anastomosis sequence is an essential issue when performing off-pump surgery. We aimed to examine the effects of this strategy on the results of off-pump coronary artery surgery.
Patients and methods
We included 601 patients with isolated coronary artery disease who underwent off-pump coronary artery bypass surgery between January 2020 and 2022. The main goal was to ensure enough blood was going through the myocardia while anastomosis was performed on one of the coroner arteries. We tried to create a strategy about the sequence in which we should do the coronary anastomosis.
Results
In 2 patients, conversion to on-pump surgery was required in elective conditions due to hemodynamic instability during the operation (0.33%). Only four patients required surgical revision because of bleeding (0.6%) in the early postoperative period. We recorded wound infections that could be solved with medical therapy and routine wound dressing in five patients (0.8%).
Conclusions
After applying this strategy, we experienced much more minor and acceptable conversion rates than those reported in the literature. We believe this strategy will benefit our colleagues who have just started practicing off-pump surgery.