Complete arterial revascularization - untouched aorta off-pump coronary surgery

Advantages:

1.                  Short- and long-term improvement of surgical results.

2.                  Improved post-operative life expectancy.

3.                  Less post-operative heart attacks.

4.                  No complications that may result in harvesting of the saphenous vein.

What is complete arterial revascularization?

The Dept. of Cardiothoracic Surgery at the Tel Aviv Sourasky Medical Center is a leader in the new concept of complete arterial revascularization.

The advantages of using arterial grafts were demonstrated in many researches, and include: short- and long-term improvement in results of surgery, and improvement of life expectancy of patients operated on using this method.  In addition, a reduction in complications related to harvesting a long section of the saphenous vein has been reported.

The arterial grafts used are the two internal thoracic arteries (also known as the left and right internal mammary arteries), or in short, LIMA and RIMA, the radial arteries (found in the forearm), and the gastro-epiploic artery.  The areas from which these arteries are "harvested" are "fed" by subsets of arterial systems that spring into action.

In our department, the current preferred method for bypass operations is to use arterial grafts.

Video clips:

Preparation of the internal mammary artery for bypass

Arterial anastomosis on a beating heart

Papers in the field of arterial revascularization - PDF version

1. Reduced strokes in the elderly: the benefits of untouched aorta off-pump coronary surgery.  Lev-Ran O et al, Ann Thorac Surg 2004;77:102-7.

Dept. of Cardiothoracic Surgery, Tel Aviv Sourasky Medical Center