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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina


P. Milojević, B. Đukanović, M. Jakovljević, V. Nešković, S. Birovljev, S. Mićović and D. Radojević
Dedinje Cardiovascular Institute, Belgrade, Yugoslavia.

Background: Off-pump coronary bypass grafting (OPCAB) could be a safer form of myocardial revascularization avoiding nonphysiological nature of cardiopulmonary bypass. Introduction of octopus 2 coronary stabilization system. Left internal mammary artery (LIMA) was used in all cases. For additional anastomoses, right internal mammary artery (RIMA), radial artery (RA), right gastroepiploic artery (GEA) or saphenous vein (SV) grafts were used. Anaesthesia with propofol and remifentanyl infusion combined with high thoracic epidural analgesia was used and early extubation was considered in all cases. Patients were kept normotermic. No additional circulatory support was used.
Results: A total of 158 anastomoses were performed, 1,78 per patient (range 1-4). All patents were extubated within 12 hours (except 2). Hospital mortality was 1,12% (1 pts). One patient (1,12%) had early reoperations because of severe graft stenosis. Except (2,37%) underwent retoracotomy due to postoperative bleeding and two patients (2,25%) had pneumothorax. One patient (1,12%) had superficial wound infection. Only 10 patients (11,24%) required postoperative blood transfusion. Early postoperative coronary angiography was performed in 8/89 patients, revealing excellent potency of all grafts except in one case.
Conclusions: Using Octopus 2 coronary stabilisation system OPCAB could be as safe as conventional coronary revascularization.

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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