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European Heart Journal 2003 24(2):121-124; doi:10.1016/S0195-668X(03)00698-X
Copyright © 2003 by the European Society of Cardiology.
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Hotline Editorial

OPCAB surgery: a voyage of discovery back to the future

R Ascione and G.D Angelini

Bristol Heart Institute, University of Bristol, Bristol, UK

The first 150 words of the full text of this article appear below.

Introduction

The resurgence of off-pump coronary artery bypass (OPCAB) surgery is rapidly changing surgical practice. After an initial phase of ‘healthy skepticism’, the impetus of some developed countries toward OPCAB surgery is remarkable. Hardly any OPCAB procedure was carried out before 1995 in the USA, however, by 1999 more than 11 000 (10%) coronary operations were performed on the beating heart.1 It is estimated that, worldwide, this percentage is currently up to 20–30%, with expectations to reach 50% by 2005.2–3 Many sceptics have becomeoptimists following the development of enabling instruments and the publication of supportive evidence as part of observational, case-matched, and prospective randomised studies.

Historical aspects

The concept of direct mammary–coronary anastomoses was advocated separately by Demikhov and Murray in animal models in the early 1950s.4–5 The first saphenous vein graft to bypass the right coronary artery was performed by Sabiston on the beating heart in 1962.6 Kolesov performed the first mammary–coronary . . . [Full Text of this Article]

The rationale

Indications

The evidence

BHACAS 1 and 2 trials
Other evidence to date
Conclusion


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