Chapter category: Heart
Historical Considerations
Off-Pump Coronary Artery Bypass Surgery
Edited by: Raymond CartierISBN: 1-58706-075-2
» Get more information about this book at landesbioscience.com «
Chapter authors:
Raymond Cartier
Recently, performing coronary artery surgery on the beating heart received prime attention even though the concept is evidently not a new one. In 1910, Alexis Carrel (Fig. 1) was the first to propose bypass surgery to correct angina pectoris,1 “In certain cases of angina pectoris, when the mouth of the coronary arteries is calcified, it would be useful to establish a complementary circulation for the lower part of the arteries”. Carrel experimentally put forth effort to develop coronary artery bypass surgery on the beating heart of a dog: “I attempted to perform an indirect anastomosis between the descending aorta and left coronary artery. It was, for many reasons, a difficult operation”. It took him 5 minutes to complete the distal anastomosis but the heart started fibrillating after 3 minutes of ischemia. This was due to cross clamping the entire pedicle of the heart to obtain a bloodless field. Nevertheless, he succeeded by massaging the heart to keep the dog alive for 2 hours. Later, Zoll2 confirmed Carrel’s premise by showing that in about 50% of fatal coronary artery occlusion cases, the occlusion had occurred in the proximal part of the left coronary artery network, leaving a distal coronary system suitable for imaginative surgical reconstruction. This would contribute to launching the modern era of direct coronary revascularization surgery. However, even before that time, others had already investigated indirect means of supplementing the deficient coronary artery system.
Additional chapters from this book:
Principles of Stabilization and Hemodynamics in OPCAB Surgery
Raymond Cartier
Stabilization of the myocardium during coronary grafting remains a major task in OPCAB surgery. In the early beginning, only the anterior territory of the heart was targeted and acceptable rudimenta...
Understanding the Mechanisms of Hemodynamic and Echocardiographic Changes during OPCAB Surgery
Pierre Couture, Andre Denault, Patrick Limoges, Peter Sheridan and Denis Babin
Coronary artery bypass grafting (CABG) on the beating heart has become a widely applied procedure. OPCAB grafting is quite attractive because of the obvious advantages of avoiding cardiopulmonary by...
Historical Considerations
Raymond Cartier
Recently, performing coronary artery surgery on the beating heart received prime attention even though the concept is evidently not a new one. In 1910, Alexis Carrel (Fig. 1) was the first to propos...
Sutureless Coronary Artery Bypass Grafting: Experimental and Clinical Progress
Kenton J. Zehr
The vision of vascular surgery became clearer in 1902, when Alexis Carrel described his triangulation technique for suturing blood vessels together.1 He experimented with vessels of many sizes and t...
Effects of Vascular-Interrupting and Hemostatic Devices on Coronary Artery Endothelial Function in Beating Heart Coronary Artery Bypass Surgery
Roland G. Demaria and Louis P. Perrault
Coronary artery bypass grafting was first conceived and experimented on by the French Nobel Prize winner in Medicine Alexis Carrel at the beginning of the previous century. 1 Sabiston, in 1962, perf...
Cardiopulmonary Bypass and Inflammation
Francois Dagenais
In the 1920s, Brukhonenko was the first to advance the concept of total body perfusion with removal of the heart.1 However, the development of a true heart-lung machine could not be fully explored u...
The Future of Coronary Artery Surgery: Quo Vadimus?
Ray C.-J. Chiu
As Dr. Paul Cartier vividly described in the Foreword of this book, there has been great progress in coronary artery surgery in the past half century. Thanks to the courageous and ingenious efforts ...
OPCAB Surgery in High Risk-Patients
Gengarr Apoo and Raymond Cartier
The advent of cardiopulmonary bypass (CPB) circulation in the past half century has revolutionized the field of cardiac surgery. Although CPB has been associated with very low morbidity, its side-ef...
Cerebral Complications Following Coronary Artery Bypass Grafting Surgery
Marzia Leache and Raymond Cartier
Cerebral complications constitute the leading cause of morbidity and disability after heart surgery. Although many cerebral deficits resolve with time, others remain a major handicap with devastatin...
Systematic OPCAB Surgery for Multivessel Disease With the CoroNeo Cor-Vasc Device
Raymond Cartier
Introduced in the mid-1960s for single vessel, OPCAB surgery is currently applicable to multivessel disease.1-4 The advent of mechanical stabilizers has been, without any doubt, a giant leap in the ...
Indications and Surgical Strategies for OPCAB
Nicolas Durrleman and Raymond Cartier
Since its reintroduction in the late 1990s, OPCAB surgery has been adopted by the inter national community in a proportion fluctuating from 1% to 98%.1,2 This large vari ability clearly reflects an ...
Potential Benefit of OPCAB Surgery
Marzia Leache and Raymond Cartier
Since the introduction of the extra-corporeal circulation (ECC) in the late fifties, its use has been seen as a necessary evil to perform surgery on the heart. The systemic inflamma tory reaction ge...
