Use of octopus 2 stabilization system for off-pump coronary artery bypass grafting

Abstract

The early results of 126 off pump CABG procedures performed through a median sternotomy incision (OPCAB) during a period of 18 months were evaluated. The mean age was 69+/-4.3 years. There were 80 male and 46 female patients. Emergency cases and reoperations were not included. A total of 268 anatomosis were performed with a mean number of 2.12 anastomosis Per patient. Conduits used were: LITA (100%), RITA (11.1%) GSV in (84%) and radial artery in (31%) of cases. In 72% of the cases, off pump surgery was chosen because of patient risk factors such as atherosclerotic aortic disease, previous CVA or carotid artery disease, renal dysfunction, malignancy and poor LV function. There was no operative mortality. One month mortality was 3 patients (2.3%). Two died because of mesentheric ischemia. 71 patients had a control angiogram before discharge. The patency of LITA anastomosis was 100% while overall patency rate was 95%. In 43 patients were an angiogram could not be performed, a Thalium 201 stress test was performed 3 months postoperatively. 38 had a normal test while 5 patients showed signs of ischemia. These patients had a control angiogram, in four patients anastomosis were patent, but in one patient tere was a severe narrowing of a venous anastomosis to the distal right coronary which was corrected with angioplasty. In the whole series 8 patients refused to have any control examination (6.3%). Our early results suggest that off pump CABG with Octopus stabilisation can be a good alternative in high risk patients who need multiple vessel revascularisation.