1. CAN SURGEONS DO COMPLETE REVASCULARIZATION IN DIABETIC
PATIENT USING OFF-PUMP TECHNIQUE?
K. Arom, V. Josakulratana, V. Pitiguagool, S. Banyatpiyaphod, P. Paamonsingh, C.
Suwanakijboriharn, S. Asavapiyanond, P. Ruengsakulrach.
Bangkok Heart Hospital, Bangkok, Thailand
Background: One argument of interventionists to proceed with miltivessels PCI +/_
DES in diabetic patients is the surgeons unable to complete bypass due to smaller native
arteries. To dispute the claim, a retrospective review of 228 DM and 221 non-DM
patients was carried out.
Material & Methods: the preoperative co-mobidity, intraoperative measurement of the
size of artery at the size of anstomosiswith difference guaged probe, and number of grafts
per patients were recorded. Post operative variables between two were copared. The
observe number of grafts(O) after surgery as compared to the number of grafts
predicted(P) before surgery. The O/P ratio of equal or better than one signifies complete
revascularization.
Results: DM are older with more co-morbidity (CHF,PVD,dialysis dependent).
The number of grafts/patient are 4.36+/-1.18(DM) and 4.33+/-1.17 (non-DM). the size of
994 DM and 956 non-DM were gauged.ther was no statistical different in size between
DM and non DM,in mm. at each artery.(RCA=1.9+/-0.3 VS 1.9+/-0.3, LAD=1.4+/-0.2
VS 1.5+/-0.2,Intm=1.2+/-0.4 VS 1.3+/-0.5, D1=1.2+/-0.2Vs1.3+/-0.4,
D2=1.1+/-0.3VS1.0+/-0.4, OM1=1.4+/-0.8VS1.4+/-0.3, OM2= 1.3+/-0.3 VS
1.3+/-0.3VS1.3+/-0.4, OM3= 0.9+/- 0.6VS1.0+/-0.6, PDA=1.4+/-0.2VS 1.4+/-0.3, PL=
1.2+/-0.2VS1.2+/-0.4). The O/P ratio: 1/1 for RCA,1/1 for LAD,1/1 for Intm, 1.12/1 for
D1, 1.4/1 for D2, 1/1 for OM1, 1/1 for OM2, 1.2/1 for OM3, 1/1 for PDA. 0.9/1 for PL.
Conclusion: DM were sicker but tolerated OPCAB as well as non-DM. Number of
grafts per patient and O/P ratio signify the ability to perform complete revascularization.
We are able to bypass the small target vessles at least equal to preop anticipant.