Surgical Spectrum
Bypass Operations on Beating-Heart without Heart-Lung Machine
OPCAB (Off-Pump-Coronary-Artery-Bypass) is the standard operation for coronary revascularization in Heart Institute Lahr / Baden since the year 2005.
Avoiding the heart-lung machine is associated with significant advantages. The contact of blood with the foreign surfaces of the heart-lung machine initiates unspecific inflammatory reactions.
These inflammatory reactions lead, to variable extents, to capillary leaks, which in turn might lead to worsening of the functions of important organs such as the kidneys, lungs and liver.
The second and possibly the more important advantage of OPCAB is that the aorta, which is commonly calcified in old people, is not touched during the operation.
During aortic cannulation or clamping in the operations performed using the heart-lung machine, small calcified particles from the aortic wall can detach and embolise to the brain arteries leading to the development of stroke.
In most of OPCAB cases both internal thoracic arteries are used as bypass grafts. The heart beats during the whole operation and only the area of the bypassed coronary artery is temporarily stabilized using, for example, the Octopus ® Stabilizer.
A positioner such as Starfish® is attached to the heart apex to fix the long axis of the heart so that the arteries on the side and back of the heart are easily reached.
A shunt is inserted into the lumen of the coronary artery during suturing the bypass graft in order to maintain the coronary blood flow without interruption.
Although performing the coronary bypass without the heart-lung machine is technically more demanding, the operative duration is not longer.
The results of OPCAB operations are very promising and clear advantages are expected especially in old patients with arteriosclerosis.
Please also take notice of the Therapy Practice
For more details please visite the Guidebook for Patients
