The clinical research of off-pump coronary artery bypass grafting by small incision at the left chest

L.-B. Xiao, Y.-H. Zhang, J.-W. Zhou, M. Yang, Y.-P. Ling, Z.-S. Gao, Y.-S. Wang

Cardio-Thoracic Surgery Department, Cangzhou Center Hospital, Cangzhou, China. drzhoujiwu@163.com

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• Cardiology

OBJECTIVE: To explore the clinical value of off-pump coronary artery bypass grafting by small incision at the left chest, and develop a better surgical regimen for coronary heart disease patients.

PATIENTS AND METHODS: 201 coronary heart disease patients who need coronary artery bypass grafting were required and randomly divided into 2 groups including a control group and an observation group. There were 107 cases in the control group who received coronary bypass grafting by extracorporeal circulation; there were 103 cases in the observation group who received off-pump coronary bypass grafting by small incision at the left chest. The duration of the mechanism ventilation, length of stay in ICU, hospitalization time, postoperative drainage volume, and the occurrence rate of complications were recorded and compared.

RESULTS: The duration of mechanism ventilation, length of stay in ICU, hospitalization time and postoperative drainage volume in the control group were (19.21 ± 1.33) hours, (5.08 ± 0.57) days, (21.20 ± 2.34) days and (997.68 ± 96.35) mL, which were (7.73 ± 0.74) hours, (2.83 ± 0.16) days, (15.67 ± 1.18) days and (901.53 ± 89.32) mL in the observation group respectively, with statistical difference between the two groups (p<0.05). The occurrence rates of renal insufficiency and arrhythmia were both 6.54% and 0.97% in the control group and the observation group, respectively. The occurrence rates of postoperative renal insufficiency and arrhythmia in the observation group were both significantly lower than those in the control group, with statistical significance analysis (p < 0.05). Postoperative low cardiac output, second thoracotomy, cerebrovascular disease, pulmonary infection, perioperative cardiac infarction and mortality did not display a significant difference between the two groups (p > 0.05).

CONCLUSIONS: Off-pump coronary artery bypass grafting by small incision at the left chest is a surgical method with less injury and fast recovery, which can be used as the preferred therapeutical method for the coronary heart disease patients who need coronary artery bypass grafting.

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