Originally introduced several decades ago, myocardial revascularization on the beating heart was largely abandoned as new techniques for extracorporeal circulation were developed. While the popularity of coronary surgery on the arrested heart remained undisputed for decades, a belief in the benefits of avoiding cardiopulmonary bypass and electromechanical arrest had sustained interest in techniques for surgery on the beating heart. Combined with the refinement of techniques of coronary exposure and myocardial stabilization, coronary surgery on the beating heart had slowly regained popularity in the 1990s. The result of an important collaboration from several international authorities in the field, Beating Heart Coronary Artery Surgery summarizes the most important and innovative developments in surgical myocardial revascularization that have evolved in recent years. The book is divided into three parts: technical aspects ("how to"); surgical approaches; and outcomes in off-pump coronary surgery. The reader will be exposed to a comprehensive review of the principles of coronary exposure, preferred surgical approaches, coronary stabilization, management of hemodynamics, graft patency verification in off-pump coronary surgery, and patient outcomes.
Table of Contents:
Contributors. Preface.
Introduction.
.
Part I. Beating Heart Coronary Artery Surgery: Overview.
1. The Evolution of Coronary Artery Grafting on the Beating Heart.
E. Buffolo, L.R. Gerola.
.
Part II. Technical Aspects: How to Do It.
2. Techniques of Left Internal Mammary Artery Harvesting.
F.B. Jatene, P.M. Pêgo-Fernandes.
3. Surgical Techniques of Coronary Artery Exposure.
R. Lima.
4. Techniques of Myocardial Stabilization.
M.A. Zenati, B.P. Griffith.
5. Graft Patency Verification in Coronary Artery Bypass Grafting: Principles and Clinical Applications.
G. D’Ancona, M. Ricci, H.L. Karamanoukian, J. Bergsland, T.A. Salerno.
6. Preserving Hemodynamics in Off-Pump Coronary Artery Bypass Grafting.
K. Von Fricken, G. D’Ancona, J. Bergsland, T.A. Salerno, H.L. Karamanoukian.
7. Conversion to Cardiopulmonary Bypass in Off-Pump Complete Coronary Artery Revascularization.
P.R. Soltoski, C.A.M. Barrozo.
8. Multivessel Coronary Revascularization: The Hybrid Approach.
M.A. Zenati, G.R. Whitman, A.J. Conrad Smith, H.A. Cohen.
9. The Use of Blood Products in Off Pump Coronary Artery Bypass Grafting.
N.D. Nader.
.
Part III. Surgical Approaches.
10. Off-Pump Complete Myocardial Revascularization Via Median Sternotomy.
M. Ricci, H.L. Karamanoukian, G. D’Ancona, J. Bergsland, T.A. Salerno.
11. The Left Anterior Small Thoracotomy Operation.
M. Contini, G. Vitolla, G. D’Addario, A.M. Calafiore.
12. Alternative Approaches for Minimally Invasive Coronary Surgery.
P.W. Boonstra, M.A. Mariani, J.G. Grandjean.
13. Reoperation Through a Left Thoracotomy: Off-Pump.
T.Z. Lajos.
14. Off-Pump Reoperations Using the Right Gastroepiploic Artery.
T.Z. Lajos.
15. Off-Pump Coronary Artery Bypass Grafting in the Presence of Calcified Aorta.
M. Ricci, H.L. Karamanoukian, G. D’Ancona, J. Bergsland, T.A. Salerno.
.
Part IV. Outcomes in Off-Pump Coronary Artery Surgery.
16. Complications in Off-Pump Coronary Artery Bypass Grafting.
A.J. Pfister.
17. Neurological Outcomes After Beating Heart Coronary Artery Bypass Surgery.
J.M. Murkin.
18. Renal Function in Off-Pump Coronary Artery Bypass Grafting.
R Ascione, GD Angelini.
19. Myocardial Revascularization on the Beating Heart in High Risk Patients.
G. D’Ancona, H.L. Karamanoukian, M. Ricci, L. Tang, T.A. Salerno, J. Bergsland.
20. Off-Pump Coronary Grafting in Elderly Patients.
M. Ricci, H.L. Karamanoukian, G. D’Ancona, J. Bergsland, T.A. Salerno.
21. Graft Patency in Off-Pump Coronary Artery Revascularization.
M.J. Mack.
22. Where Are We Going? The Operating Room in the New Millennium.
E. Fosse, P.K. Hol, J.S. Rørtnes.
Index
