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Current randomized control trials, observational studies and meta analysis in off-pump coronary surgery
Haralabos Parissis1, Man Chi Lau2, Mondrian Parissis2
1Cardiothoracic Department, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK & Northern Ireland. hparissis@yahoo.co.uk.
Journal of Cardiothoracic Surgery
|December 19, 2015
Summary
Off-pump cardiac surgery shows promise for reducing stroke incidence, especially with aortic non-touch techniques. Combined off-pump and hybrid procedures may benefit high-risk elderly patients.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Minimally Invasive Cardiac Surgery
Background:
- The debate on off-pump versus on-pump cardiac surgery has evolved through distinct phases.
- While no definitive superiority has been established, specific techniques warrant attention.
Purpose of the Study:
- To review the last decade of research on the off-pump versus on-pump cardiac surgery debate.
- To provide insights for practitioners regarding current evidence and conclusions.
Main Methods:
- Review of randomized control trials (RCTs) and meta-analysis studies.
- Analysis of literature from the early, intermediate, and contemporary phases of off-pump surgery research.
Main Results:
- Small RCTs and meta-analyses suggest a stroke incidence below 1% with aortic off-pump techniques, particularly the non-touch method.
- Off-pump surgery combined with hybrid procedures may reduce adverse outcomes in elderly, high-risk patients with comorbidities and poor left ventricular function.
Conclusions:
- Aortic off-pump techniques, especially the non-touch method, show potential for reducing stroke risk.
- Combined off-pump and hybrid approaches may offer benefits for specific high-risk patient populations.
