First results of a single Heartstring aortotomy for multiple off-pump venous bypasses

Coronary artery bypass grafting is still a relevant intervention for myocardial revascularization, particularly in complex multi-vessel coronary disease. This study describes and analyzes the outcome of a newly developed and already published operative technique, the “Single Heartstring aortotomy for multiple off-pump venous bypass grafts”. The analysis is designed as a retrospective study, recruiting patients, operated by the above-mentioned method. All interventions were performed by a single surgeon at the University Hospital of Lausanne in Switzerland. Patients having had the “Single Heartstring aortotomy for multiple grafts” off-pump surgery from 2011 until 2017 were enrolled in the study. The retrospective analysis focused on in-hospital early 30 days and midterm follow-up (cardiac and non-cardiac related) mortality and morbidity (non-fatal myocardial infarction, re-revascularization, and stroke). Eighteen patients, mainly men over 70 years old, with a mean EuroSCORE II of 2.59 % and STS score mortality risk of 3.78%, were identified and all of them included. Altogether, 62 anastomoses were performed, among them, 40 venous anastomoses. Results were promising, showing that the new coronary artery bypass grafting technique is feasible and safe, with its special advantage of combining a minimalized aortic manipulation, a beating heart approach with low systemic anticoagulation and a reduced, procedure related, myocardial ischemia, which could be of particular interest in high-risk patients