Abstract
Purpose
Cerebrovascular accidents after coronary artery bypass grafting (CABG) remain a complication despite the advancements in techniques. Aortic partial clam** should be avoided to prevent this cerebral complication. We use pedicle arterial grafts (bilateral internal-mammary arteries and the right gastroepiploic artery) and saphenous vein graft with a proximal anastomosis device for off-pump CABG without aortic partial clam**. We call this technique the aortic nonclam** technique.
Methods
Between 2001 and 2007, a total of 468 patients underwent coronary bypass operations; 8 who were operated on with cardiopulmonary bypass were excluded from this study. Altogether, 451 patients underwent off-pump CABG using the aortic nonclam** technique. Among the procedures, 354 were performed using pedicle arterial grafts alone, and 99 were done using a saphenous vein graft with a proximal anastomosis device. Nine were performed with aortic partial clam** for any reason. Postoperative cerebral complications, especially cerebral infarction, were analyzed.
Results
Cerebral infarction occurred in two cases (0.47%) in the aortic nonclam** group. They were delayed in both cases, one occurring on the third day after operation and the other on the fourth day. One patient in the aortic clam** group had an intraoperative (early) cerebral infarction.
Conclusion
The aortic nonclam** technique might reduce the incidence of cerebral complications and produce ideal bypass grafts using arterial grafts and saphenous vein grafts with a proximal anastomosis device.
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Osawa, H., Inaba, H., Kinoshita, O. et al. Off-pump coronary artery bypass grafting with an aortic nonclam** technique may reduce the incidence of cerebral complications. Gen Thorac Cardiovasc Surg 59, 681–685 (2011). https://doi.org/10.1007/s11748-011-0795-z
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DOI: https://doi.org/10.1007/s11748-011-0795-z