TITLE

Off-Pump Coronary Artery Bypass Grafting and Transmyocardial Laser Revascularization

AUTHOR(S)
Gregoric, Igor; Messner, Gregory; Couto, Wilson J.; Sartori, Michele; Cervera, Roberto; Kadipasaoglu, Kamuran; Frazier, O.H.
PUB. DATE
March 2003
SOURCE
Texas Heart Institute Journal;2003, Vol. 30 Issue 1, p13
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Off-pump coronary artery bypass grafting may be combined with adjunctive transmyocardial laser revascularization to optimize revascularization. This approach may be advantageous for high-risk patients, particularly those having undergone previous sternotomies. From October 2000 through May 2001, 17 patients (9 women and 8 men) underwent off-pump coronary artery bypass grafting and transmyocardial laser revascularization via a left thoracotomy. The patients had a mean age of 63 years and a mean ejection fraction of 0.33. All but 1 patient had undergone previous coronary surgery. In each patient, the heart was approached via a left thoracotomy through the 5th intercostal space, and 37 transmural channels, 1 mm in diameter, were each created with a single pulse of the carbon dioxide laser. Coronary artery bypass grafting was then performed with left internal thoracic artery or saphenous vein grafts. The follow-up period ranged from 2.1 to 9.3 months (mean, 6.2 months). The patients received 28 bypass grafts (mean, 1.6 grafts). Postoperatively, 2 patients required inotropic support. On day 8, 1 patient died of ventricular fibrillation. After a mean hospitalization of 7.7 days, the remaining patients were discharged, free of angina. At follow-up examination after a mean of 6 months (range, 2-9 months), 15 patients remained free of angina and one had mild angina. None had required further hospitalization. Performed via a left thoracotomy, off-pump coronary artery bypass grafting plus transmyocardial laser revascularization yielded an acceptable mortality rate, no major morbidity, and substantial angina relief in this carefully selected group of challenging, high-risk patients. (Tex Heart Inst J 2003;30:13-8)
ACCESSION #
9334470

 

Related Articles

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics