The potential advantage of "no-touch" aortic technique in off-pump complete arterial revascularization

Objectives: Off-pump coronary artery bypass grafting (OPCAB) and complete arterial revascularization without proximal anastomosis to the aorta may decrease neurological events after open-heart surgery. Few reports exist regarding the combination of OPCAB and complete arterial revascularization exploring the theoretical advantage of avoiding manipulation of the aorta. We review our results in I 10 patients who underwent multiple grafts off-pump complete arterial revascularization. Methods: I 10 patients underwent multiple grafts OPCAB complete arterial revascularization, and were compared to 216 patients who underwent traditional multiple grafts on pump CABG. Preoperative renal failure was 12.7% (n = 14) as compared to 5.1%, (n = 11, p = 0.01) in the control group and 33.6% (n = 37) of the patients were 75 years or older as compared to 19.0% (n = 41, p = 0.003) in the control group. Results: The mean number of grafts per patient undergoing multiple OPCAB complete arterial revascularization was 2.3, as compared to 3.11 in the control group (p < 0.001). The mortality rate was 2.73% as compared to 1.85% (NS) in the control group. The incidence of CVA was 0% as compared to 2.31% (p = 0.17) in the control group. Conclusions: Complete arterial OPCAB revascularization without manipulation of the aorta in high-risk patients can be performed with short-term similar results to conventional CABG and very low neurological complications. (c) 2006 Elsevier Ireland Ltd. All rights reserved.