Abstract
Surgical coronary artery bypass grafting (CABG) is the standard of care for revascularization of left main or three-vessel coronary artery disease. The off-pump coronary artery bypass graft (OPCAB) procedure avoids the use of cardiopulmonary bypass. Theoretically, OPCAB may improve long-term outcomes by reducing the rates of perioperative myocardial injury, stroke, neurocognitive impairment, and cardiac-related mortality. Several high-quality clinical trials have been conducted since OPCAB became popular in the 1990s and have demonstrated no benefit of OPCAB over traditional CABG with respect to these outcomes despite favorable short-term reductions in transfusion requirements and other postoperative complications. Ultimately, OPCAB is associated with less effective myocardial revascularization and does not entirely prevent complications traditionally associated with cardiopulmonary bypass. This article reviews major high-quality trials of OPCAB versus traditional CABG with respect to both short- and long-term clinical outcomes.
| Original language | English (US) |
|---|---|
| Journal | Journal of Cardiothoracic and Vascular Anesthesia |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- cardiopulmonary bypass
- coronary artery bypass grafting
- coronary artery graft patency
- off-pump coronary artery bypass grafting
- surgical revascularization
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Anesthesiology and Pain Medicine
Cite this
Off-Pump Versus On-Pump Coronary Artery Bypass Grafting—A Systematic Review and Analysis of Clinical Outcomes. / Shaefi, Shahzad; Mittel, Aaron; Loberman, Dan; Ramakrishna, Harish.
In: Journal of Cardiothoracic and Vascular Anesthesia, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Off-Pump Versus On-Pump Coronary Artery Bypass Grafting—A Systematic Review and Analysis of Clinical Outcomes
AU - Shaefi, Shahzad
AU - Mittel, Aaron
AU - Loberman, Dan
AU - Ramakrishna, Harish
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Surgical coronary artery bypass grafting (CABG) is the standard of care for revascularization of left main or three-vessel coronary artery disease. The off-pump coronary artery bypass graft (OPCAB) procedure avoids the use of cardiopulmonary bypass. Theoretically, OPCAB may improve long-term outcomes by reducing the rates of perioperative myocardial injury, stroke, neurocognitive impairment, and cardiac-related mortality. Several high-quality clinical trials have been conducted since OPCAB became popular in the 1990s and have demonstrated no benefit of OPCAB over traditional CABG with respect to these outcomes despite favorable short-term reductions in transfusion requirements and other postoperative complications. Ultimately, OPCAB is associated with less effective myocardial revascularization and does not entirely prevent complications traditionally associated with cardiopulmonary bypass. This article reviews major high-quality trials of OPCAB versus traditional CABG with respect to both short- and long-term clinical outcomes.
AB - Surgical coronary artery bypass grafting (CABG) is the standard of care for revascularization of left main or three-vessel coronary artery disease. The off-pump coronary artery bypass graft (OPCAB) procedure avoids the use of cardiopulmonary bypass. Theoretically, OPCAB may improve long-term outcomes by reducing the rates of perioperative myocardial injury, stroke, neurocognitive impairment, and cardiac-related mortality. Several high-quality clinical trials have been conducted since OPCAB became popular in the 1990s and have demonstrated no benefit of OPCAB over traditional CABG with respect to these outcomes despite favorable short-term reductions in transfusion requirements and other postoperative complications. Ultimately, OPCAB is associated with less effective myocardial revascularization and does not entirely prevent complications traditionally associated with cardiopulmonary bypass. This article reviews major high-quality trials of OPCAB versus traditional CABG with respect to both short- and long-term clinical outcomes.
KW - cardiopulmonary bypass
KW - coronary artery bypass grafting
KW - coronary artery graft patency
KW - off-pump coronary artery bypass grafting
KW - surgical revascularization
UR - http://www.scopus.com/inward/record.url?scp=85046674693&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046674693&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2018.04.012
DO - 10.1053/j.jvca.2018.04.012
M3 - Article
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
ER -