1. Carly Sproule BE 2352 Sec 2 29 November 2011

2.  Background  Traditional Heart Surgery  Advancements  Off Pump Coronary Artery Bypass  Benefits  Disadvantages  Conclusion

3.  Patent ductus arteriosus (PDA) ligation  Coarctation of the aorta repair  Atrial septal defect (ASD) repair  Ventricular septal defect (VSD) repair  Coronary Artery Bypass Figure 1

4.  Heart-lung machine  Heart doesn’t pump for 30-90 minutes  Easier to operate on heart Figure 2

5. Figure 6

6.  Closed Heart Surgery ◦ Thoracotomy Incision ◦ Sternotomy Incision  Off-pump coronary artery bypass (OPCAB) Figure 3

7. Figure 4

8.  Medtronic's Starfish ® 2 and Urchin ® Heart Positioners  The Medtronic Octopus ® Tissue Stabilizer  Adenosine and Esmolol Figure 5

9.  Shorter recovery time  25% cheaper on average  Fewer complications during surgery  Less weight gain, kidney stress, blood vessel damage, swelling of the brain, etc

10.  Female : ◦ GFR(mL/min)=0.85*(140-age)*(bodyweight) 72(serum creatinine)  Male: ◦ GFR(mL/min)=(140-age)*(bodyweight) 72(serum creatinine)  GFR: Glomerular filtration rate  Age: years  Bodyweight: kg  Serum creatinine: mg/dL

11.  Sometimes fewer grafts are performed  The grafts aren’t as tight  Long term difficulties not studied well

12.  The Off-Pump Coronary Artery Bypass procedure shows great promise; however, long-term studies need to be conducted to show that the grafts still function well after 15 or more years of use.

13.  Figure1 http://heartsickandheadstrong.blogspot.com/2010/04/wido wmaker.html http://heartsickandheadstrong.blogspot.com/2010/04/wido wmaker.html  Figure 2 and Figure 3 http://www.health.harvard.edu/newsletters/off-pump- bypass-surgery-promise-unfulfilled http://www.health.harvard.edu/newsletters/off-pump- bypass-surgery-promise-unfulfilled  Figure 4 http://biomed.brown.edu/Courses/BI108/BI108_2000_Group s/Heart_Surgery/OPCAB.htm http://biomed.brown.edu/Courses/BI108/BI108_2000_Group s/Heart_Surgery/OPCAB.htm  Figure 5 and Figure 6 http://www.medtronic.com/patients/coronary-artery- disease/therapy/beating-heart-bypass-surgery/what-is- beating-heart-bypass-surgery/ http://www.medtronic.com/patients/coronary-artery- disease/therapy/beating-heart-bypass-surgery/what-is- beating-heart-bypass-surgery/