Anaortic, Total-arterial, Off-pump Coronary Artery Bypass Surgery: How To Do It

Vallely, Michael P.; Yan, Tristan D.; Edelman, James; Hayman, Mark; Brereton, R. John L.; Ross, Donald E.

doi:10.1016/j.hlc.2010.04.078

Cited by 19 publications

(8 citation statements)

References 21 publications

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“…However, several studies performed by units with expertise in OPCAB demonstrated equivalency between techniques [2,8]. Recent technical advances, including the use of mechanical stabilisers and intracoronary shunts have improved the quality of anastomoses and completeness of myocardial revascularisation [9]. A recently published follow-up study of two randomised trials showed no difference in graft patency (or outcomes of MACCE and death) between OPCAB and CABG at six to eight years [8].…”

Section: T He Synergy Between Percutaneous Coronary Intervention Withmentioning

confidence: 99%

Coronary Artery Bypass Grafting With and Without Manipulation of the Ascending Aorta – A Meta-Analysis

Edelman

Yan

Bannon

et al. 2011

Heart, Lung and Circulation

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Section: T He Synergy Between Percutaneous Coronary Intervention Withmentioning

confidence: 99%

Coronary Artery Bypass Grafting With and Without Manipulation of the Ascending Aorta – A Meta-Analysis

Edelman

Yan

Bannon

et al. 2011

Heart, Lung and Circulation

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“…However, in the early 1990s, several groups described its use as a composite Y or T graft proximally anastomosed to the internal thoracic artery (ITA) to increase the number of distal anastomoses and allow a more complete arterial revascularization. The extreme application of this concept is the use of the RA as a termino-terminal elongation graft from the right ITA to achieve total arterial and aortic revascularization [28].…”

Section: Proximal Anastomosis and Target Vessel Characteristicsmentioning

confidence: 99%

Technical Aspects of the Use of the Radial Artery in Coronary Artery Bypass Surgery

Gaudino

Fremes

Schwann

et al. 2019

The Annals of Thoracic Surgery

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Background. The radial artery has been used for coronary artery bypass surgery for more than 25 years. The recent confirmation of the clinical benefits associated with the use of the artery is likely to drive a new interest toward this conduit in the next few years.Methods. A group of surgeons with extensive experience in the systematic use of the radial artery summarize here the key technical aspects of the use of the conduit for coronary bypass operations.Results. Preoperative evaluation of the ulnar collateral circulation and attention to the characteristics of the target vessel are keys for the successful use of the radial artery. Open or endoscopic harvesting can be used,

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“…The fact that neurological morbidity is always higher in bypass surgery in comparison with PCI has led to searches to reduce neurological morbidity. In 2010, Vallely described a simple and reproducible technique for coronary artery revascularization without touching the aorta (anaortic), total arterial off‐pump (anOPCAB) 6 . As a result of the more widespread use of this technique, a meta‐analysis of a total of 37,720 patients from 13 studies covering 6 important networks was published in 2017 7 .…”

Section: Introductionmentioning

confidence: 99%

“…In 2010, Vallely described a simple and reproducible technique for coronary artery revascularization without touching the aorta (anaortic), total arterial off-pump (anOPCAB). 6 As a result of the more widespread use of this technique, a meta-analysis of a total of 37,720 patients from 13 studies covering 6 important networks was published in 2017. 7 It has been a turning point for minimally invasive coronary bypass surgery that the avoidance of aortic manipulation has been demonstrated to reduce the rates of perioperative stroke, and that avoiding cardiopulmonary bypass also reduces short-term mortality, renal failure, atrial fibrillation, bleeding, and length of stay in the intensive care unit.…”

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confidence: 99%

Minimally invasive off‐pump anaortic coronary artery bypass (MACAB)

Mavioglu¹,

Vallely²

2022

Journal of Cardiac Surgery

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Background Minimally invasive direct coronary artery bypass has enabled coronary artery bypass graft to compete with the appeal of less invasive percutaneous coronary procedures. Favorable results of coronary artery bypass surgery performed without the use of cardiopulmonary bypass and without touching the aorta (anOPCAB) have enabled the development and use of minimally invasive methods. Methods Between 2016 and 2021, 112 patients underwent multivessel coronary bypass surgery performed using a minimally invasive method through a small thoracotomy in the left chest with off‐pump, anaortic, and all‐arterial grafts (Minimally Invasive Off‐Pump Anaortic Coronary Artery Bypass [MACAB]). Patient data were collected and retrospectively analyzed. Eight series from the literature using the multivessel mini‐OPCAB and MACAB technique were also evaluated. Results Collectively, from the literature, 2729 patients underwent an average of 2.4 bypasses with an early mortality rate of 0.7% and a stroke rate of 0.16%. In our MACAB case series, 112 patients underwent an average of 2.9 bypasses with a mortality rate of 1.8% and a stroke rate of 0%. Conclusion MACAB can be performed safely by experienced surgeons and reduces neurological injury and surgical trauma and may be a good alternative for multivessel stenting. Simulation systems are essential for its dissemination, and teams dedicated to coronary surgery—with subspecialty expertise—are necessary to achieve good outcomes.

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Anaortic, Total-arterial, Off-pump Coronary Artery Bypass Surgery: How To Do It

Cited by 19 publications

References 21 publications

Coronary Artery Bypass Grafting With and Without Manipulation of the Ascending Aorta – A Meta-Analysis

Coronary Artery Bypass Grafting With and Without Manipulation of the Ascending Aorta – A Meta-Analysis

Technical Aspects of the Use of the Radial Artery in Coronary Artery Bypass Surgery

Minimally invasive off‐pump anaortic coronary artery bypass (MACAB)

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