YEAR EXPERIENCE WITH OCTOPUS 2 CORONARY STABILIZATION SYSTEM
P. Milojević, B. Đukanović, M. Jakovljević, V. Nešković, S.
Birovljev, S. Mićović and D. Radojević
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.