La rivascolarizzazione coronarica senza circolazione extracorporea: Indicazioni attuali, tecnica chirurgica e risultati

Translated title of the contribution: Myocardial revascularisation without extracorporeal circulation: Indications, surgical technique and results

Research output: Contribution to journalArticle

Abstract

Background. This study was undertaken to assess our experience of the evolution, over time, of beating heart surgery in the Cardiologic Center Foundation "Monzino". Methods. From March 1995 to June 2000, 506 patients underwent myocardial revascularization on beating heart: 313 until May 1999, and 193 between June 1999 and June 2000, after the advent of coronary artery stabilizers and shunts, to keep the surgical field bloodless, with minimal motion and continuous myocardial perfusion. Surgical accesss was via a median sternotomy for 408 cases and via a left anterior thoracotomy for 98 cases. Results. The indications by choice increased, from I to II period, from 61% to 83% with special situations in which patients had three-vessel coronary artery disease raised from 33% to 50%, concerning also bypass grafts performed on circumflex artery and right coronary increased. Postoperative mortality in hospital decreased from 1.3% to 0.5% and perioperative IMA (acute myocardial infarction) from 3.8% to 0.5% in patients undertaken to median thoracotomy. Hospital stay decreased from 8 to 7 days about [no significant differences with patients who underwent CPB (cardiopulmonary bypass)]; in patients who underwent to MTS (left anterior minithoracotomy) there was no deaths, IMA decreased from 3.9% to 0% and hospital stay from 6 to 5 days. Grafts patency increased from 92.3% to 100%. Conclusions. To perform completed revascularisations is possible now even on the beating heart, and also to make precise anastomosis as on pump CABG, in a reproducible and easy way. The beating heart procedure, that is also more economical, might be expanded to all patients, not only high risk patients.

Original languageItalian
Pages (from-to)297-305
Number of pages9
JournalMinerva Cardioangiologica
Volume49
Issue number5
Publication statusPublished - Oct 2001

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Myocardial Revascularization
Extracorporeal Circulation
Thoracotomy
Length of Stay
Coronary Vessels
Transplants
Sternotomy
Hospital Mortality
Cardiopulmonary Bypass
Thoracic Surgery
Coronary Artery Disease
Perfusion
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{48ef77f9db5846978113036e40436807,
title = "La rivascolarizzazione coronarica senza circolazione extracorporea: Indicazioni attuali, tecnica chirurgica e risultati",
abstract = "Background. This study was undertaken to assess our experience of the evolution, over time, of beating heart surgery in the Cardiologic Center Foundation {"}Monzino{"}. Methods. From March 1995 to June 2000, 506 patients underwent myocardial revascularization on beating heart: 313 until May 1999, and 193 between June 1999 and June 2000, after the advent of coronary artery stabilizers and shunts, to keep the surgical field bloodless, with minimal motion and continuous myocardial perfusion. Surgical accesss was via a median sternotomy for 408 cases and via a left anterior thoracotomy for 98 cases. Results. The indications by choice increased, from I to II period, from 61{\%} to 83{\%} with special situations in which patients had three-vessel coronary artery disease raised from 33{\%} to 50{\%}, concerning also bypass grafts performed on circumflex artery and right coronary increased. Postoperative mortality in hospital decreased from 1.3{\%} to 0.5{\%} and perioperative IMA (acute myocardial infarction) from 3.8{\%} to 0.5{\%} in patients undertaken to median thoracotomy. Hospital stay decreased from 8 to 7 days about [no significant differences with patients who underwent CPB (cardiopulmonary bypass)]; in patients who underwent to MTS (left anterior minithoracotomy) there was no deaths, IMA decreased from 3.9{\%} to 0{\%} and hospital stay from 6 to 5 days. Grafts patency increased from 92.3{\%} to 100{\%}. Conclusions. To perform completed revascularisations is possible now even on the beating heart, and also to make precise anastomosis as on pump CABG, in a reproducible and easy way. The beating heart procedure, that is also more economical, might be expanded to all patients, not only high risk patients.",
keywords = "Coronary artery bypass instrumentation, Coronary artery bypass methods",
author = "M. Zanobini and A. Mantovani and A. Cannata and G. Pompilio and Polvani, {G. L.} and A. Parolari and F. Alamanni and M. Agrifoglio and P. Biglioli",
year = "2001",
month = "10",
language = "Italian",
volume = "49",
pages = "297--305",
journal = "Minerva Cardioangiologica",
issn = "0026-4725",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "5",

}

TY - JOUR

T1 - La rivascolarizzazione coronarica senza circolazione extracorporea

T2 - Indicazioni attuali, tecnica chirurgica e risultati

AU - Zanobini, M.

AU - Mantovani, A.

AU - Cannata, A.

AU - Pompilio, G.

AU - Polvani, G. L.

AU - Parolari, A.

AU - Alamanni, F.

AU - Agrifoglio, M.

AU - Biglioli, P.

PY - 2001/10

Y1 - 2001/10

N2 - Background. This study was undertaken to assess our experience of the evolution, over time, of beating heart surgery in the Cardiologic Center Foundation "Monzino". Methods. From March 1995 to June 2000, 506 patients underwent myocardial revascularization on beating heart: 313 until May 1999, and 193 between June 1999 and June 2000, after the advent of coronary artery stabilizers and shunts, to keep the surgical field bloodless, with minimal motion and continuous myocardial perfusion. Surgical accesss was via a median sternotomy for 408 cases and via a left anterior thoracotomy for 98 cases. Results. The indications by choice increased, from I to II period, from 61% to 83% with special situations in which patients had three-vessel coronary artery disease raised from 33% to 50%, concerning also bypass grafts performed on circumflex artery and right coronary increased. Postoperative mortality in hospital decreased from 1.3% to 0.5% and perioperative IMA (acute myocardial infarction) from 3.8% to 0.5% in patients undertaken to median thoracotomy. Hospital stay decreased from 8 to 7 days about [no significant differences with patients who underwent CPB (cardiopulmonary bypass)]; in patients who underwent to MTS (left anterior minithoracotomy) there was no deaths, IMA decreased from 3.9% to 0% and hospital stay from 6 to 5 days. Grafts patency increased from 92.3% to 100%. Conclusions. To perform completed revascularisations is possible now even on the beating heart, and also to make precise anastomosis as on pump CABG, in a reproducible and easy way. The beating heart procedure, that is also more economical, might be expanded to all patients, not only high risk patients.

AB - Background. This study was undertaken to assess our experience of the evolution, over time, of beating heart surgery in the Cardiologic Center Foundation "Monzino". Methods. From March 1995 to June 2000, 506 patients underwent myocardial revascularization on beating heart: 313 until May 1999, and 193 between June 1999 and June 2000, after the advent of coronary artery stabilizers and shunts, to keep the surgical field bloodless, with minimal motion and continuous myocardial perfusion. Surgical accesss was via a median sternotomy for 408 cases and via a left anterior thoracotomy for 98 cases. Results. The indications by choice increased, from I to II period, from 61% to 83% with special situations in which patients had three-vessel coronary artery disease raised from 33% to 50%, concerning also bypass grafts performed on circumflex artery and right coronary increased. Postoperative mortality in hospital decreased from 1.3% to 0.5% and perioperative IMA (acute myocardial infarction) from 3.8% to 0.5% in patients undertaken to median thoracotomy. Hospital stay decreased from 8 to 7 days about [no significant differences with patients who underwent CPB (cardiopulmonary bypass)]; in patients who underwent to MTS (left anterior minithoracotomy) there was no deaths, IMA decreased from 3.9% to 0% and hospital stay from 6 to 5 days. Grafts patency increased from 92.3% to 100%. Conclusions. To perform completed revascularisations is possible now even on the beating heart, and also to make precise anastomosis as on pump CABG, in a reproducible and easy way. The beating heart procedure, that is also more economical, might be expanded to all patients, not only high risk patients.

KW - Coronary artery bypass instrumentation

KW - Coronary artery bypass methods

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M3 - Articolo

C2 - 11533549

AN - SCOPUS:0035486728

VL - 49

SP - 297

EP - 305

JO - Minerva Cardioangiologica

JF - Minerva Cardioangiologica

SN - 0026-4725

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