Off-pump (Beating Heart) coronary artery bypass grafting (OPCAB) was implemented to reduce trauma during surgical coronary revascularization. High thoracic epidural anesthesia further reduced intra operative stress and postoperative pain. This technique also supports awake coronary artery bypass (ACAB), completely avoiding the drawbacks of mechanical ventilation and general anesthesia in high-risk patients. We compared our first results of the ACAB procedure with the conventional operation on the beating heart in several published articles.
Continuation of thoracic epidural analgesia provides better pain control and faster mobilization after such procedures. Surprisingly, the ACAB procedure was well accepted by the patients.
Awake Coronary Artery Bypass was performed first 2000 in Ankara and 2001 at the University of Frankfurt. More than 30 patients could be discharged on the same day of surgery. This kind of painless bypass surgery with very fast recovery sounds like coronary stent implantation.
1) Aybek T, Kessler P, Khan MF, Dogan S, Neidhart G, Moritz A, Wimmer-Greinecker G. Operative techniques in awake coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2003 Jun;125(6):1394-400.
2) Aybek T, Kessler P, Dogan S, Neidhart G, Khan MF, Wimmer-Greinecker G, Moritz A. Awake coronary artery bypass grafting: utopia or reality? Ann Thorac Surg. 2003 Apr;75(4):1165-70.
3) Aybek T, Dogan S, Neidhart G, Kessler P, Matheis G, Wimmer-Greinecker G, Moritz A. Coronary artery bypass grafting through complete sternotomy in conscious patients. Heart Surg Forum. 2002;5(1):17-20; discussion 20-1.