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Related Experiment Videos

Current results in off pump surgery.

M Contini1, A Iacò, T Iovino

  • 1Department of Cardiac Surgery, University G. D'Annunzio, Chieti, Italy.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|October 28, 1999
PubMed
Summary
This summary is machine-generated.

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Myocardial revascularization without cardiopulmonary bypass (CPB) offers comparable early and mid-term outcomes to traditional CPB surgery. Patients undergoing off-pump procedures experienced faster recovery and fewer complications.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Techniques
  • Minimally Invasive Cardiac Surgery

Background:

  • Traditional myocardial revascularization often utilizes cardiopulmonary bypass (CPB).
  • Assessing alternative techniques like off-pump surgery is crucial for patient outcomes.

Purpose of the Study:

  • To compare early and mid-term results of myocardial revascularization performed with and without cardiopulmonary bypass (CPB).
  • To evaluate the safety and efficacy of off-pump coronary artery bypass grafting.

Main Methods:

  • A comparative study of 747 patients undergoing isolated myocardial revascularization: 480 off-pump (Group A) and 267 on-pump (Group B).
  • Specific surgical techniques for vessel exposure and anastomosis in off-pump procedures were detailed.
  • Key outcomes including mortality, cerebrovascular accident, myocardial infarction, and recovery parameters were analyzed.

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Main Results:

  • Crude and risk-adjusted mortality and incidence of cerebrovascular accident and acute myocardial infarction were similar between groups.
  • Off-pump patients (Group A) showed significantly improved recovery: earlier waking, reduced inotrope use, lower peak CK-MB, less bleeding, fewer transfusions, and shorter ICU and hospital stays.
  • Graft patency rates were high (98.5% patent, 97.0% patent and non-restrictive) for checked anastomoses.

Conclusions:

  • Myocardial revascularization without CPB yields favorable early and mid-term results in selected patients.
  • Primary endpoints (death, acute myocardial infarction) were comparable regardless of technique.
  • While some secondary endpoints favored off-pump surgery, the benefit for high-risk patients with comorbidities remains an area for further scientific investigation.