“Off-pump” coronary artery bypass grafting: the first one hundred cases of the Rose City experience

Background. In an effort to avoid the adverse effects of cardiopulmonary bypass, “off-pump” myocardial revascularization has been rediscovered and refined. This study reviews the first 100 off-pump coronary artery bypass procedures performed in Tyler, TX, and compares the results with those reported in the Seventh Annual Report of the Society of Thoracic Surgeons (STS) Cardiac Surgery Database. Methods. Coronary artery bypass was performed on 100 patients without cardiopulmonary bypass over a 24-month period. Postoperative morbidity, mortality, and length of stay were recorded. Results. Operative mortality was 3%. The incidences of postoperative complications for the off-pump group versus the STS database were as follows: reoperation for bleeding, 1% vs 2.2%; transfused patients, 15% vs 35%; atrial fibrillation, 5% vs 18.2%; infection, 2% vs 1.3%; neurologic, 0% vs 5.1%; renal failure, 0% vs 3.12%; ventilation more than 1 day, 0% vs. 5.69%. The postoperative length of stay for the off-pump group versus the STS group was 4.4 vs 6.6 days. Conclusions. Early results suggest that off-pump coronary artery bypass grafting is a safe and effective means of coronary revascularization with excellent short-term results and minimal morbidity.