Intermittent Pump Support for Beating Heart Cabg
OBJECTIVE: ‘Beating Heart CABG On Intermittent Pump Support’ is a more reliable method of coronary revascularization which takes the advantage of off and on pump CABG while eliminates the disadvantage of both the technique.
METHODS: From January 2015 to December 2021 a new technique “Intermittent On pump beating heart CABG” using suction stabilizer was used by putting aortic and venous canula electively in all the patients. Patients were supported by pump intermittently, as and when required (Group 1, n = 254 ). A retrospective data was collected from our record of the patients who underwent off pump CABG electively by the same surgeon and team (Group 2, n= 254).
RESULTS: Significant advantage was noted in Group 1 patients in terms of number of graft ( 3.31 ± 1.16 vs 2.30 ±0.66 ), grafting of lateral vessels ( 316 vs 202), mean operating time ( 1.37 ± 0.23 hrs vs 2.22 ± 0.45 hrs ) and post operative blood loss ( 406.30 ± 257.90 ml vs 567.41 ± 265.20 ml ). CPB support time was less than 15 minutes in majority of patients (n = 179, 70.37 % ) with a mean of 16.81 minutes. It was required particularly during grafting of lateral vessels. A rise in enzymes level (CRP , CKMB, Trop I and NT Pro BNP) was noted in Group 1 patients . But, these did not affected the postoperative course in patients. There was no mortality in Group 1 patients while 4 of patients in Group 2 died.
COCLUSIONS: Intermittent on pump CABG technique is promising method of surgical revascularization for all the patients requiring CABG. It has shown its superiority in terms of safety, number of grafts, operating time and better perioperative course.
Keyword - Cardiopulmonary Bypass, CABG, Beating Heart CABG, On pump CABG