Off-pump coronary artery bypass grafting using microvascular technique and surgical microscope. (Immediate results)

Objective. To analyze in-hospital outcomes of off-pump coronary artery bypass grafting (CABG) using microvascular technique and surgical microscope. Material and methods. Analysis included the first 100 patients who underwent off-pump CABG between September 2021 and October 2024. Clinical status, incidence of complications and patency of grafts at discharge were evaluated. Results. Surgery time was 188.7±40.5 min, the number of distal anastomoses — 3 (2; 3). Complete anatomical revascularization was performed in 81% of patients. CABG without manipulations on the aorta was performed in 74 (74%) patients, elective conversion to cardiopulmonary bypass (CPB) — in 2 (2%) patients. ICU-stay was 1 (1; 1) day. There were no cases of myocardial infarction after surgery. The incidence of postoperative stroke, acute kidney injury and respiratory failure was 2%, 14% and 4%, respectively. Renal replacement therapy was required in 2 (2%) patients. Emergency repeated CABG was performed in 1 (1%) patient. The 30-day mortality was 2%. Postoperative hospital-stay was 12 (10; 14) days. Graft patency was evaluated in 90 (90%) patients. The overall graft patency was 92.6%. Conclusion. Surgical microscope and microsurgical technologies can be routinely used for off-pump CABG to improve the quality and outcomes of surgeries in patients who are justified in refusing CPB.