A comparison of several variables of off-pump coronary artery bypass procedures versus myocardial revascularization utilizing cardiopulmonary bypass

Perfusion ◽  
2002 ◽  
Vol 17 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Debra L Zarro ◽  
David A Palanzo ◽  
Ralph M Montesano
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Length Of Hospital Stay ◽  
Postoperative Management ◽  
Off Pump ◽  
Several Variables ◽  
Pump Coronary Artery Bypass

An investigation was conducted to compare several variables of off-pump coronary artery bypass (OPCAB) procedures with those using cardiopulmonary bypass (CPB) for myocardial revascularization by two surgeons. The patients were divided into four groups: group 1 patients received CPB for their myocardial revascularization performed by surgeon A; group 2 patients received the OPCAB procedure performed by surgeon A; group 3 patients received CPB for their myocardial revascularization performed by surgeon B; and group 4 received the OPCAB procedure performed by surgeon B. The same anesthesia technique and postoperative management were employed for all patients in this study. The CPB procedures received the same perfusion circuit and conduct. Postoperative laboratory values, including hemoglobin, hematocrit and platelet counts for the OPCAB groups, were higher than the CPB groups. Chest tube drainage was similar for both the OPCAB and CPB groups, but postoperative urine outputs were significantly higher in the CPB groups for both surgeons. Positive fluid balance was statistically greater in the CPB groups compared to the OPCAB groups for both surgeons. Ventilator times, length of stay in the intensive care unit (ICU) and length of hospital stay were not statistically significant for the groups in this study. Postoperative weight gain for both surgeons was higher in the CPB groups. Intraoperative packed red blood cell (PRBC) usage for surgeon B was similar for both the OPCAB and CPB groups, but the OPCAB group for surgeon A had greater intraoperative PRBC usage than the CPB group.

Off-Pump Coronary Artery Bypass is an Alternative to Conventional Cardiopulmonary Bypass When Repair of Traumatic Coronary Artery Injuries is Indicated

2007 ◽  
Vol 73 (3) ◽  
pp. 296-298 ◽  
Author(s):  
Forrest O. Moore ◽  
John D. Berne ◽  
William F. Turner ◽  
David H. Villarreal ◽  
Thomas Mcgovern ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Coronary Artery Ligation ◽  
Cardiac Perfusion ◽  
Cardiac Trauma ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

Coronary artery injuries after penetrating cardiac trauma are rare. The standard approach to these injuries has traditionally been coronary artery ligation. When cardiac perfusion is profoundly compromised, cardiopulmonary bypass has been used to facilitate revascularization, although with serious morbidity. We report a case of traumatic left anterior descending coronary artery transection repaired off-pump in a young stabbing victim. Penetrating traumatic cardiac injuries are highly lethal injuries. Cardiopulmonary bypass has been used for myocardial revascularization when cardiac perfusion is compromised, although with significant complications. Off-pump coronary artery bypass is a safe alternative in the traumatized patient.

Off-Pump Coronary Artery Bypass Grafting and Stroke—Exploratory Analysis of the GOPCABE Trial and Methodological Considerations

2018 ◽  
Vol 66 (06) ◽  
pp. 464-469 ◽  
Author(s):  
Michael Zacher ◽  
Jochen Boergermann ◽  
Utz Kappert ◽  
Michael Hilker ◽  
Gloria Färber ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Pump Cabg ◽  
Pump Coronary Artery Bypass

Background Coronary artery bypass grafting (CABG) without cardiopulmonary bypass (off-pump CABG) may reduce severe adverse events including stroke. Methods In the German Off-Pump Coronary Artery Bypass Grafting in Elderly patients trial, the rate of major adverse cardiovascular events was compared in 2,394 elderly (≥ 75 years) patients undergoing CABG with (on-pump) or without (off-pump) cardiopulmonary bypass. This exploratory post-hoc analysis investigated the impact of surgical aortic manipulation on the rate of stroke. Results There was no significant difference in the rate of stroke within 30 days after surgery between both groups (off-pump: 2.2%; on-pump: 2.7%; odds ratio [OR]: 0.83 [0.5–1.38]; p = 0.47). Within the off-pump group, different degrees of aortic manipulation did not lead to significant different stroke rates (tangential clamping: 2.3%; OR 0.86 [0.46–1.60]; clampless device: 1.8%; OR 0.67 [0.26–1.75]; no aortic manipulation: 2.4%; OR 0.88 [0.37–2.14]). An aggregate analysis including more than 10,000 patients out of the four recent major trials also yielded comparable stroke rates for on- and off-pump CABG (off-pump: 1.4%; on-pump: 1.7%; OR 0.87 [0.64–1.20]). Conclusion Within recent prospective randomized multicenter trials off-pump CABG did not result in lower stroke rates. The possible intrinsic benefit of off-pump CABG may be offset by the complexity of the operative therapy as well as the multiple pathomechanisms involved in perioperative stroke.

scholarly journals Coronary Endarterectomy with off Pump Coronary Artery Bypass Surgery- A Review

2017 ◽  
Vol 10 (1) ◽  
pp. 84-90
Author(s):  
Redoy Ranjan ◽  
Dipannita Adhikary ◽  
Heemel Saha ◽  
Sanjoy Kumar Saha ◽  
Sabita Mandal ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Graft Patency ◽  
Coronary Endarterectomy ◽  
Off Pump ◽  
Diffuse Coronary Artery Disease ◽  
Artery Disease ◽  
Pump Coronary Artery Bypass

Coronary endarterectomy is first described as an alternative surgical procedure for myocardial revascularization against diffuse coronary artery disease by Baily et al. in 1956. Coronary endarterectomy provides complete surgical revascularization of the myocardium in diffuse and calcified coronary arteries with adequate blood flow to distal part of occluded arteries, thus improving ventricular function. However, the initial outcomes of coronary endarterectomy were not satisfactory but now-a-days different studies have shown that coronary endarterectomy with coronary artery bypass grafting can be done safely with acceptable morbidity and mortality. Moreover, the graft patency rate on angiographic evaluation is also good following coronary endarterectomy. So, it’s time to reevaluate this old techniques, and reanalysis the current outcomes of coronary endarterectomy and readdress its indication in diffuse coronary artery diseaseCardiovasc. j. 2017; 10(1): 84-90

scholarly journals Is postoperative cognitive decline after cardiac surgery associated with plasma beta amyloid 1–42 levels?

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Zrinka Požgain ◽  
Grgur Dulić ◽  
Goran Kondža ◽  
Siniša Bogović ◽  
Ivan Šerić ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Cognitive Decline ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Off Pump ◽  
Bypass Group ◽  
Postoperative Cognitive Decline ◽  
Pump Coronary Artery Bypass

Abstract Background Postoperative cognitive decline following cardiac surgery is one of the frequently reported complications affecting postoperative outcome, characterized by impairment of memory or concentration. The aetiology is considered multifactorial and the research conducted so far has presented contradictory results. The proposed mechanisms to explain the cognitive decline associated with cardiac surgery include the neurotoxic accumulation of β-amyloid (Aβ) proteins similar to Alzheimer's disease. The comparison of coronary artery bypass grafting procedures concerning postoperative cognitive decline and plasmatic Aβ1-42 concentrations has not yet been conducted. Methods The research was designed as a controlled clinical study of patients with coronary artery disease undergoing surgical myocardial revascularization with or without the use of a cardiopulmonary bypass machine. All patients completed a battery of neuropsychological tests and plasmatic Aβ1-42 concentrations were collected. Results The neuropsychological test results postoperatively were significantly worse in the cardiopulmonary bypass group and the patients had larger shifts in the Aβ1-42 preoperative and postoperative values than the group in which off-pump coronary artery bypass was performed. Conclusions The conducted research confirmed the earlier suspected association of plasmatic Aβ1-42 concentration to postoperative cognitive decline and the results further showed that there were less changes and lower concentrations in the off-pump coronary artery bypass group, which correlated to less neurocognitive decline. There is a lot of clinical contribution acquired by this research, not only in everyday decision making and using amyloid proteins as biomarkers, but also in the development and application of non-pharmacological and pharmacological neuroprotective strategies.

scholarly journals Off Pump Coronary Artery Bypass in patients with severe LV dys-function. Is it really more challenging?

2021 ◽  
Author(s):  
Panagiotis Sarris-Michopoulos ◽  
Evan Markell ◽  
Alejandro Macias ◽  
Michael Magarakis
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Off Pump ◽  
Pump Cabg ◽  
Artery Disease ◽  
Pump Coronary Artery Bypass ◽  
Stable Field ◽  
Low Ejection Fraction

CABG (Coronary Artery Bypass Grafting) has been the treatment of choice for coronary artery disease for over 50 years and is the most common cardiac surgery procedure performed. Traditionally CABG was performed with the use of cardiopulmonary bypass and the use of cardioplegia to allow the surgeon to operate on a stable field. In the mid-1990s, interest emerged in performing CABG without the use of cardiopulmonary bypass - off pump CABG. This invited commentary focuses on sharing our experience with Low Ejection fraction off-pump CABG and why this approach could be beneficial to this patient population.

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