OPCAB as a Standard in Coronary Surgery: Single-centre Experience

Igor Chernov, Dmitry Kozmin, Dmitry Kondratyev, Sergey Makeev, Soslan Enginoev, Gasan Magomedov, Dmitry Tarasov

Federal Centre for Cardiovascular Surgery (Astrakhan), Astrakhan, Russia

Date, time and location: 2018.05.25 13:30, Congress Hall, 2F–A

Abstract

Objective: to study the efficiency and safety of OPCAB on the basis of 5313 operations performed in one center by a single methodology.

Materials and methods: During a period from 2009 to 2015 a total amount of 6556 patients (87.5% males; 59.2 + 7.4 years) . The vast majority of them (5313, 81%) were operated using OPCAB. Patient selection criteria for OPCAB, Isolated myocardial revascularization.

Results: Revascularization index was 3.2 ± 0.09 (1-7 distal anastomoses ). The LIMA was used in 96%; SVG-91%; RA-34.5%. BIMA was used in 2% patients since 2013. Routine use of the AXIUS coronary shunt, ligation of LAA is commonly performed in patients with atrial fibrillation, intraoperative TTFM and epiaortic ultrasound. 53 patients (1%) required conversion to cardiopulmonary bypass, mainly patients with an increased LV EDV , with a low EF. We have observed postoperative complications: perioperative myocardial infarction - 0.7%; stroke - 0.4%; mediastinitis - 1%; AF - 5.6%; IABP and ECMO - 0.6%. Hospital mortality rate was 0.8%.

Conclusion: The key point in achieving the optimal result of OPCAB is the well thought-out selection of patients and the accumulation of collective experience of such operations in the clinic. OPCAB technique has become a standard approach in our department with low mortality rate.