Coronary angiography was performed systematically during the first postoperative month in 20 patients. The technique described here is easily performed, inexpensive, and efficacious. The exposure of the posterolateral wall, which was very difficult to obtain at the beginning of this type of surgery, is now feasible. The inferior wall is more easily exposed. These artifices make bypasses of the circumflex branches and of the right coronary distal branches possible, and more complete revascularization is now achieved.
Some limitations remain, however.
We think that patients with intramyocardial LAD or diffuse atheromatous disease are not good candidates for off-pump grafting. Such patients have been excluded in this report. No postoperative myocardial infarction occurred in these selective patients. The current quality of anastomoses seems excellent. The short-term clinical results are good with 71 patients symptom free.