Off-Pump Coronary Artery Bypass

Carly SprouleBE 2352 Sec 2

29 November 2011

Background Traditional Heart Surgery Advancements Off Pump Coronary Artery Bypass Benefits Disadvantages Conclusion

Overview

Patent ductus arteriosus (PDA) ligation Coarctation of the aorta repair Atrial septal defect (ASD) repair Ventricular septal defect (VSD) repair Coronary Artery Bypass

Reasons to Have Traditional Heart Surgery

Figure 1

Heart-lung machine Heart doesn’t pump for 30-90 minutes Easier to operate on heart

Traditional Heart Surgery

Figure 2

Heart-Lung Bypass Machine

Figure 6

Closed Heart Surgery◦ Thoracotomy Incision◦ Sternotomy Incision

Off-pump coronary artery bypass (OPCAB)

Advancements

Figure 3

OPCAB

Figure 4

Medtronic's Starfish®2 and Urchin® Heart Positioners

The Medtronic Octopus® Tissue Stabilizer

Adenosine and Esmolol

OPCAB

Figure 5

Shorter recovery time 25% cheaper on average Fewer complications during surgery Less weight gain, kidney stress, blood

vessel damage, swelling of the brain, etc

Benefits

Female: ◦ GFR(mL/min)=0.85*(140-age)*(bodyweight)

72(serum creatinine) Male:

◦ GFR(mL/min)=(140-age)*(bodyweight)

72(serum creatinine) GFR: Glomerular filtration rate Age: years Bodyweight: kg Serum creatinine: mg/dL

Cockcroft-Gault

Sometimes fewer grafts are performed The grafts aren’t as tight Long term difficulties not studied well

Disadvantages

The Off-Pump Coronary Artery Bypass procedure shows great promise; however, long-term studies need to be conducted to show that the grafts still function well after 15 or more years of use.

Conclusion

Figure1 http://heartsickandheadstrong.blogspot.com/2010/04/widowmaker.html

Figure 2 and Figure 3 http://www.health.harvard.edu/newsletters/off-pump-bypass-surgery-promise-unfulfilled

Figure 4 http://biomed.brown.edu/Courses/BI108/BI108_2000_Groups/Heart_Surgery/OPCAB.htm

Figure 5 and Figure 6 http://www.medtronic.com/patients/coronary-artery-disease/therapy/beating-heart-bypass-surgery/what-is-beating-heart-bypass-surgery/

Works Cited