[Off-pump coronary artery bypass]. / Pomostowanie aortalno-wiencowe bez uzycia krazenia pozaustrojowego.

Development of beating heart coronary artery bypass surgery was possible since introduction of heart stabilizing instruments in mid-90's. THE AIM OF THIS REVIEW: To summarize available evidence of benefits of beating heart coronary artery bypass surgery in comparison with use of cardiopulmonary bypass during surgery. Methods of heart stabilization during operation without cardiopulmonary bypass allow to performing complete revascularization with lower degree of myocardial damage. The main advantage of beating heart coronary bypass surgery is excluding systemic inflammatory response following cardiopulmonary bypass use. And therefore less incident of renal failure, clotting disturbances, respiratory complications. There is lower incidence of microthrombotic formation and central nervous system complications. Early mortality is significantly lower and it is safer to operate on high risk patients (over 75 years old, female, with acute coronary syndrome, ascending aorta arteriosclerosis). CONCLUSION: The technique of beating heart coronary artery bypass surgery reduces risk of central nervous system complications, renal failure, respiratory problems and coagulation disturbances. The complete revascularisation is possible. This technique is available to enlarging group of patients, especially the high perioperative risk patients.

[Off-pump coronary artery bypass grafting and left ventricular aneurysm resection--a case report]. / Skojarzona operacja pomostowania tetnic wiencowych oraz resekcja tetniaka lewej komory bez uzycia krazenia pozaustrojowego--opis przypadku.

We present the case of a 55-year-old patient with coronary heart disease of class III of the Canadian Cardiovascular Society (CCS), after cardiac antero-lateral wall infarction at unknown time. Coronarography revealed 90% occlusion of three branches of left coronary artery. Ventriculography showed dyskinetic aneurysm of apex and anterior wall without presence of thrombus. On the basis of the performed examination the patient was qualified to off-pump coronary artery bypass (OPCAB) and left ventricular aneurysm resection (LVAn). On the beating heart with the use of Octopus II stabilizer distal (side to side) anastomosis was performed to marginal branch and (end to side) to circumflex as a jump graft. Subsequently left internal thoracic artery to left anterior descending branch anastomosis was performed. And then, on the beating heart on the two Teflon pads entry of aneurysm was closed by the mattress sutures. Next the aneurysm was resected and closed with additional continuous suture. There were non operative and post-operative complications.