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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

CORONARY ARTERY BYPASS GRAFTING ON THE BEATING HEART, OUR EXPERIENCE
E. Mujanović, J. Bergsland, M. Hadžiselimović, M. Softić, A. Azabagić and E. Kabil
Cardiovascular Clinic, University Clinical Center Tuzla, Bosnia and Herzegovina

Objective: This study compares preoperative basic demographic data, risk factors, postoperative morbidity and mortality in patients undergoing coronary artery bypass grafting (CABG) in cardiovascular Clinic Tuzla. Patients were divided in two groups depending on operative method applied.
Methods: Between September 1998 and March 2000, 323 patients underwent CABG. Patients were divided in two groups: group A consisted of 196 patients who underwent CABG with the use of cardiopulmonary bypass (CPB) and group B with 127 patients who had CABG without using CPB. In the group A, median sternotomy was the uniform surgical approach. Then, cannulation of the ascending aorta and right atrium myocardial protection were performed with cold anterograde and/or retrograde cardioplegia. In the group B, median sternotomy was used in all cases except two, where a left anterior small thoracotomy was performed. For the adequate exposure of the target vessel, the so called LIMA stitch (named after dr. Ricardo Lima, Recife, Brazil) was used. Stabilisation of the target vessel was accomplished with pressure type stabiliser (Cardiothoracic systems Cupertino California, USA).
Results: The number of patients with major postoperative complications was higher in the group A (9,18%) than in the group B (6,29%). There were no deaths in the group B while 8 patients died in the group A (4,08%). Overall mortality was 2,47%.
Conclusion: Although the number of patients in our early experience was not high, the results presented in this study suggest that CABG without CPB seems to be safe and effective technique with minimal morbidity and mortality.

Keywords: Coronary artery bypass grafting, cardiopulmonary bypass, morbidity, mortality.

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