Beating-heart coronary artery bypass graft surgery at San Raffaele Hospital: four years of experience.

OBJECTIVE

To review the database of 1,902 consecutive patients who underwent coronary artery bypass graft (CABG) surgery in the period 1998 through 2001 at this institution, and to compare the preoperative status, anesthetic management, and postoperative outcome of 364 patients with the beating-heart technique with 1,538 patients who underwent the operation on cardiopulmonary bypass.

DESIGN

Observational study.

SETTING

University hospital.

PARTICIPANTS

Consecutive patients (n = 1,902) who underwent CABG surgery in the period 1998 through 2001.

MEASUREMENTS AND MAIN

RESULTS

Comparison (chi-square test) of the preoperative status shows that surgeons' choice for the beating-heart technique was based on the presence of severe preoperative comorbidities: renal impairment (p < 0.0001), chronic obstructive pulmonary disease (p < 0.04), and low ejection fraction (p < 0.0001). On a multivariate analysis, the beating-heart technique was associated with reduced transfusion needs and duration of mechanical ventilation.

CONCLUSION

Beating-heart surgery is gaining popularity as a safe method for myocardial revascularization. Excellent results have been achieved with this technique in this center.