Off-pump coronary operation at the Favaloro foundation: Results in 264 patients

Background. Our objective was to determine whether complete myocardial reva scularization "off pump" was feasible while maintaining the efficacy of con ventional surgical techniques. Methods. 264 patients were operated on between March 15, 1998, and August 2 6, 1999. A total of 218 (82.6%) were men and the average age was 61.4 years (range 28 to 57 years). Left main occlusions were present in 10.2% and 84% had multiple vessel disease. A total of 628 grafts were implanted, an aver age of 2.4 grafts per patient. Total arterial revascularization was achieve d in 81.5% using both internal mammary arteries and the radial artery, one or more venous grafts in 18.1%, and venous alone in 0.3%. Results. Surgical mortality was 2.2% and perioperative myocardial infarctio n was 3%. There were no neurologic events in this group of patients. In the first 73 patients coronary angiography control tvas performed before disch arge and all grafts were patent. Angioplasty was carried out in 2 patients (0.76%) and conversion of procedure in 4 (1.5%). Follow-up time was 4 to 14 months. Conclusions. This procedure enabled revascularization of all areas of the h eart, usually with total arterial revascularization, and excellent patency rates. The morbidity and mortality observed was similar to conventional sur gery. The incidence of secondary complications (bleeding, need for transfus ion, prolonged mechanical ventilation, or neurologic events) was lower. (An n Thorac Surg 2000;70:1030-3) (C) 2000 by The Society of Thoracic Surgeons.