TITLE:
Re-engineering in OPCAB—A Vettath’s perspective
AUTHORS:
Murali P. Vettath, Et Ismail, Av Kannan
KEYWORDS:
CABG (Coronary Artery Bypass Grafting); OPCAB (Off Pump Coronary Artery Bypass); ONCAB (On Pump Coronary Artery Disease); Diffuse Coronary Artery Disease; IABP (Intra-Aortic Balloon Pump); CPB (Cardiopulmonary Bypass)
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.4A,
July
18,
2013
ABSTRACT:
OPCAB (off pump coronary artery bypass) has become
a preferred technique of coronary revascularization in India, and more so in
the East. This technique was restarted by Buffalo and Bennetti who had
published their results in 1985. Since then, there has been a great enthusiasm
among coronary surgeons to develop and standardize this technique of CABG
(coronary artery bypass grafting). In the late nineties, nearly all the
coronary centers in India started performing this technique. But, by the
early 2000, only a few surgeons continued this practice. Only those who could
perform this OPCAB technique in nearly 100% of their patients continued this
and the rest of them returned back to the conventional on pump CABG. To attain
this result, we had to re-engineer our technique of anesthesia, surgical
technique, stabilization, and positioning of the heart to enable us to perform
OPCAB in all patients who needed CABG. We have analyzed our last 3000 patients
operated by the same surgeon (Dr MPV), in the same center with the same team.
As OPCAB was the only procedure performed for coronary revascularization, we
have compared our first 1000 patients, with the second 2000 patients that
underwent the procedure. Our technique and our results are presented.