Abdullah Ashmeg, Raheel Hussain, Ziauddin A Kashmiri, Rana M Hameed, Masood Iiameed Khan.
Total arterial revascularization on beating heart: short experience of 35 cases.
Med Channel Jan ;13(4):14-7.

OBJECTIVE: To avoid the deleterious effects of cardiopulmonary bypass causing spasm in arterial conduits especially radial artery, total arterial revascularization was performed on beating heart, using an Octopus stabilizer. PATIENTS AND METHODS: This is an observational study of 35 patients who had coronary artery bypass grafting using all arterial conduits. Single-vessel disease was present in 32 patients, double-vessel disease in 8, and triple-vessel disease in 28, one patient had left main involvement. Poor left ventricular (LV) function with ejection fraction < 35% was found in 16(45.7%) cases. Remaining 19 patients had normal or mildly compromised LV function. Grafts included left and right internal mammary arteries, and single or both radial arteries. There were a total of 95 grafts placed with a mean of 2.71 (SD=0.75, range 1- 4) grafts per patient. RESULTS: There was one operative mortality. There was no postoperative stroke or renal impairment. Blood transfusion was not required in 4(11.4%) patients. Mean hospital stay was 4.5 days. CONCLUSION: Total arterial revascularization on the beating heart was found to be safe, and effective in all patients with minimal morbidity. It prevents radial arterial spasm. Calcium channel blocker therapy may not be needed. Patients needed to be encouraged for repeat angiogram after of surgery to assess graft patency.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com