The aortic no-touch OPCAB technique, using multiple arterial grafts allows complete revascularisation of the heart with no manipulation of the ascending aorta.

This reduces the rate of stroke to less than 1%,

The long term survival improves with increased graft patency (use of bilateral mammary arterial and radial artery grafts and avoidance of vein grafts)

The technique is suitable for the majority of cases with less than 15% of cases requiring cardiopulmonary bypass for haemodynamic reasons: ventricular arrhythmias, mitral regurgitation and raised pulmonary pressures or heart failure with a large ventricle.  The most common graft configuration is using the left radial to extend the RIMA and pass the extension graft behind the aorta to reach the lateral and inferior walls.


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Written by Michael Wilson
Professor Michael Wilson is a leading cardiothoracic surgeon with clinical appointments at Macquarie University Hospital, Mater Hospital, Chris O’Brien Lifehouse, Northern Beaches Hospital and John Flynn Hospital Gold Coast. Professor Wilson has a special interest in the utilisation of emerging technologies and minimally invasive techniques to deal with complex heart and lung surgical problems. He holds an academic appointment at Macquarie University and has extensive experience in clinical and basic science research.
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