Suzuki Tomoaki1, Asai Tohru2. 1. Department of Cardiovascular Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, 520-2192, Japan. suzukit@belle.shiga-med.ac.jp. 2. Department of Cardiovascular Surgery, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, 520-2192, Japan.
Abstract
PURPOSE: Off-pump coronary artery bypass surgery has not become widespread because of its technical difficulty. However, especially in Asia, pioneer surgeons continue with efforts to develop the off-pump technique. METHOD: By reviewing past studies, mainly retrospective single-center reports, an up-to-date profile of off-pump surgery was assembled. RESULTS: Many of the past randomized trials failed to demonstrate the advantages of off-pump surgery. Although many of these were single-center retrospective studies, the data presented, mostly from world-famous surgeons, show that off-pump surgery does have advantages in high-risk patients and results in reduced rates of postoperative morbidity and equal rates of mortality in both the short- and long terms. Moreover, almost all experienced off-pump surgeons noted the benefit of multiple uses of arterial grafts, skeletonization harvesting of arterial conduits and the aorta no-touch technique. CONCLUSION: The off-pump procedure has not become a standard technique performed by the average surgeon in daily practice. However, off-pump surgery will continue to provide a significant benefit to high-risk patients with coronary disease.
PURPOSE: Off-pump coronary artery bypass surgery has not become widespread because of its technical difficulty. However, especially in Asia, pioneer surgeons continue with efforts to develop the off-pump technique. METHOD: By reviewing past studies, mainly retrospective single-center reports, an up-to-date profile of off-pump surgery was assembled. RESULTS: Many of the past randomized trials failed to demonstrate the advantages of off-pump surgery. Although many of these were single-center retrospective studies, the data presented, mostly from world-famous surgeons, show that off-pump surgery does have advantages in high-risk patients and results in reduced rates of postoperative morbidity and equal rates of mortality in both the short- and long terms. Moreover, almost all experienced off-pump surgeons noted the benefit of multiple uses of arterial grafts, skeletonization harvesting of arterial conduits and the aorta no-touch technique. CONCLUSION: The off-pump procedure has not become a standard technique performed by the average surgeon in daily practice. However, off-pump surgery will continue to provide a significant benefit to high-risk patients with coronary disease.
Authors: Mark D Peterson; Michael A Borger; Vivek Rao; Charles M Peniston; Christopher M Feindel Journal: J Thorac Cardiovasc Surg Date: 2003-11 Impact factor: 5.209
Authors: André Lamy; P J Devereaux; Dorairaj Prabhakaran; David P Taggart; Shengshou Hu; Ernesto Paolasso; Zbynek Straka; Leopoldo S Piegas; Ahmet Ruchan Akar; Anil R Jain; Nicolas Noiseux; Chandrasekar Padmanabhan; Juan-Carlos Bahamondes; Richard J Novick; Prashant Vaijyanath; Sukesh Kumar Reddy; Liang Tao; Pablo A Olavegogeascoechea; Balram Airan; Toomas-Andres Sulling; Richard P Whitlock; Yongning Ou; Janice Pogue; Susan Chrolavicius; Salim Yusuf Journal: N Engl J Med Date: 2013-03-11 Impact factor: 91.245