This placebo control study investigated the efficacy and safety of ramosetron [Nasea] on corrected QT interval in patients undergoing off pump coronary artery
Learn what to expect from beating heart bypass surgery or off-pump coronary artery bypass surgery. Medtronic makes the tissue stabilizers that help make this surgery possible.
The intense debate of earlier years between off-pump coronary artery bypass (OPCAB) grafting and conventional coronary artery bypass grafting (CABG) with the use of cardiopulmonary bypass (CPB) has recently given place to a more balanced and targeted approach to surgical coronary revascularisation. Baseline patient characteristics, coronary and aortic pathology and, most importantly, surgeon experience and training are currently the main factors influencing the decision and implementation of OPCAB. In an era where outcomes following CABG are closely monitored and mortality rarely exceeds 3%, the practice of off-pump revascularisation aims at amelioration of morbidity and at achieving equivalent, if not superior, outcomes compared with on-pump CABG. However, a systematic and indepth analysis of the relevant literature highlights an important issue, which is often neglected and could potentially influence decision making in coronary artery surgery: this is intraoperative conversion.1. Institution ...
Introduction: Acute kidney injury (AKI) is a common postoperative complication of cardiac surgery, which is associated with an increased risk of morbidity and mortality. This study investigated the frequency of postoperative AKI in low risk adult patients undergoing off-pump coronary artery bypass grafting (CABG).Materials & Methods: All consecutive adult patients of American Society of Anesthesiologists (ASA) class II and III, who were transferred to the post-operative cardiac surgery ICU after off-pump CABG and were low risk for AKI from October 2013 to September 2014 at Emam Reza Hospital, Mashhad, Iran were enrolled in this prospective cohort study at a teaching hospital. The patients were explored for AKI development, based on risk-injury-failure-loss- end stage kidney disease (RIFLE) and acute kidney injury network (AKIN) criteria, frequency of metabolic acidosis, hypernatremia, hyperchloremia, and length of stay in ICU.Results: According to the results of the present study, 479 patients with the
BACKGROUND: Neurocognitive dysfunction remains a limitation of cardiac surgery with cardiopulmonary bypass. Intraoperative cerebral microembolization is believed to be one of the most important etiologic factors. Using a new generation of transcranial Doppler ultrasonography, we compared the number and nature of intraoperative microemboli in patients undergoing on-pump and off-pump cardiac surgery procedures. METHODS: Bilateral continuous transcranial Doppler monitoring of the middle cerebral arteries was performed in 45 patients (15 off-pump coronary artery bypass grafting, 15 on-pump coronary artery bypass grafting, and 15 open cardiac procedures). All recordings were performed using a multi-range, multifrequency system to allow both measurement of the number and discrimination of the nature of microemboli in the 3 different groups. RESULTS: The median number (interquartile range) of microemboli in the off-pump coronary artery bypass grafting, on-pump coronary artery bypass grafting, and open
OBJECTIVES: Acute kidney injury (AKI) is one of the most frequently occurring complications after off-pump coronary artery bypass graft (OPCAB). Hyperglycaemia is a major, potentially modifiable risk factor of adverse outcome after cardiac surgery known to aggravate organ damage. The aim of this study was to address the association between intraoperative glucose concentration and postoperative AKI in patients who underwent OPCAB. METHODS: The medical records of 880 consecutive patients were retrospectively reviewed. Patients were divided into three groups according to the time-weighted average of intraoperative glucose concentrations (,110, 110-150 and ,150 mg/dl), and the incidence of AKI (increase of serum creatinine to ,2.0 mg/dl and 2 × most recent preoperative value or a new requirement for dialysis) was compared. Multivariate logistic regression analysis was performed to identify independent risk factors for postoperative AKI. RESULTS: The incidence of AKI was higher in patients with a ...
Dr Eugene Sim is a Cardiothoracic Surgeon practicing at Mount Elizabeth Hospital and Gleneagles Hospital, Singapore. He has performed more than 3000 cases of open heart surgery. Dr Eugene Sim is renowned for his pioneering work in cardiac surgery.. In Nov 1995, Dr Eugene Sim was one of the first surgeons in Asia to perform minimally invasive direct coronary artery bypass grafting and has performed more than 100 such procedures to date. He was also the first surgeon in Asia to perform off-pump coronary artery bypass grafting using the Octopus stabilizer and has conducted many training courses to train surgeons in the use of this new technique.. He was one of the first surgeons in the region to perform thoracoscopic ligation of a patent ductus arteriosus in Dec 1995, Thoracoscopic anterior release for scoliosis in January 1996, thoracoscopic thymectomy in 1997, multivessel off pump coronary artery bypass grafting in July 1997 and robotic assisted coronary artery bypass surgery in April 2000. Dr ...
The initial application of off-pump coronary artery bypass in the early nineties was mainly directed to highly selected and relatively low risk surgical patients. Since then there has been a growing body of evidence suggesting many potential advantages of the OPCAB technique over the conventional cardiopulmonary bypass (CPB) technique in different groups of high-risk patients.. On-off study is a multicentre, prospective, randomized, parallel, trial.Patients indicated for elective or urgent isolated coronary artery bypass graft with additive European System for Cardiac Operative Risk Evaluation ≥ 6 were enrolled. Patients in cardiogenic shock were excluded. Patients were randomly assigned either to coronary artery bypass surgery with cardiopulmonary bypass (ON arm) or to off-pump coronary artery bypass graft (OFF arm). The composite primary end point included operative mortality, myocardial infarction, stroke, renal failure, re-operation for bleeding and adult respiratory distress syndrome, ...
Anaesthetic implications during off-pump coronary artery bypass surgery-IJCA-Print ISSN No:-2394-4781 Online ISSN No:-2394-4994Article DOI No:-10.18231/2394-4994.2018.0060,Indian Journal of Clinical Anaesthesia-IP Innovative Publication Pvt Limited, Medical Journals Publication, Open Access Journals, Print Journals,I
Off-pump Coronary Artery Bypass,Medical Illustration database of the best portfolios and stock images now features General and Commercial Illustration and illustrators. 8,000+ image database includes all types of subjects and features the largest directory of medical, science, and nature illustrators and illustration on the web.
Background: Benefits of off-pump CABG (OPCAB) compared with conventional on-pump CABG (CCAB) still has been controversial. However, it is important to investigate which patient subgroups may benefit more from OPCAB rather than CCAB.. Methods and Results: Among the patients undergoing first PCI or CABG enrolled in the CREDO-Kyoto Registry (a registry of first-time PCI and CABG patients in Japan), 2468 patients undergoing CABG were entered into the study (67 ± 9 y.o.). Predicted risk of operative mortality (PROM) of each patient was calculated by logistic EuroSCORE. Patients were divided into tertile based on their PROM. Mortality rates and the incidences of cardiovascular events were compared between CCAB and OPCAB within each PROM tertile using propensity-score analysis. (Table) A total of 1376 patients received CCAB and 1092 did OPCAB. Observed 30-day mortality in whole population was similar between CCAB and OPCAB (odds ratio [95% confidence interval]: 1.18 [0.93-1.51], p=0.17). Observed ...
Coronary artery bypass surgery is commonly known as CABG. Its a type of heart surgery. Surgeons do this type of surgery to bypass blockages in the coronary arteries.
Recovery slope is a marker of microcirculation. The tissue oxygen saturation (StO2) using InspectraTM StO2 (Hutchinson Technology Inc.,USA) will be recorded continuously. The InspectraTM StO2 probe will be placed on the skin of the thenar eminence and the blood pressure cuff will be wrapped around the arm. After performing vascular occlusion test, the recovery slope will be calculated by the software ...
BACKGROUND: Preoperative creatinine values higher than 2.5 mg/dL are associated with markedly increased risk for both mortality and morbidity in patients undergoing coronary artery bypass surgery. We aimed to determine the effects of prophylactic per
Teresa Kieser 1, M Sarah Rose1, Mouhieddin Traboulsi2, Kishan Narine1. 1University of Calgary, Calgary, AB Canada, 2Llibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB Canada.. Objective: Off-pump coronary artery bypass graft (CABG) surgery and total arterial grafting (TAG) are not commonly coincident. This study compares the early safety and efficacy of total arterial CABG in off- and on-pump surgery.. Methods: A prospective cohort of all consecutive CABG-only patients from 2003-2012 was analyzed to compare short-term outcomes of off-pump with on-pump patients.. Results: From July 2003 to March 2012, 937 patients underwent CABG with 98% arterial grafts (2727/2782). From April 2008 onward, 79% (322/408) of CABG was performed off-pump. Prior to this only 6% (31/529) of CABG was done off-pump and was mainly for single-vessel disease or ascending aortic calcification. For off-pump/on-pump respectively TAG was performed in 94% (333/353)/96% (561/584) patients and 98% ...
Off-pump coronary artery bypass grafting is better than on-pump in patients with STEMI underwent surgery within 2 days from onset of symptoms. Surgeons may be reluctant to use OPCAB due to concerns about completeness of myocardial revascularization and graft patency. The aim of this study was to assess long-term clinical outcomes and graft patency in this kind of patients. Participants in two previous randomized studies performed in our institution including 207 STEMI patients underwent emergent or urgent CABG within 48 hours from onset of symptoms were followed after surgery to assess graft patency and major adverse cardiac-related events (MACE). There were 145 patients operated in on-pump and 62 patients in off-pump. Patency was assessed by multidetector computed tomography coronary angiography (MDCTA) with a 64-slice scanner. Two blinded observers classified proximal, body and distal segments of each graft as occluded or not, or grade of stenosis. Clinical follow-up was obtained by our ...
Fifty-nine trials were included, encompassing 8,961 patients, with a mean age of 63.4 and 16% females. There was a significant 30% reduction in the occurrence of postoperative stroke with OPCAB (risk ratio [RR], 0.70; 95% confidence interval [CI], 0.49-0.99). There was no significant difference in mortality (RR, 0.90; 95% CI, 0.63-1.30) or myocardial infarction (pooled RR, 0.89; 95% CI, 0.69-1.13). In the meta-regression analysis, the effect of OPCAB on all of the clinical outcomes was similar regardless of mean age, proportion of females in the trial, number of grafts per patient, and trial publication date.. ...
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Sternal wound complications (SWC) are a rare but potentially life-threatening complication after coronary artery bypass grafting (CABG) surgery. Especially the use of bilateral IMA (BIMA) grafts as opposed to single IMA (SIMA) grafts is associated with an increased risk of SWC. Skeletonised harvesting has been proposed to reduce this risk. The purpose of this study was to retrospectively investigate the effect of skeletonisation on SWC after off-pump coronary artery bypass grafting (OPCAB) in a centre with a high volume of off-pump procedures and high frequencies of BIMA. From January 2010 to November 2016, 1900 consecutive patients underwent OPCAB surgery at the University Hospitals of Leuven. The first group (n = 1487) received non-skeletonised IMA grafts, whereas the second group (n = 413) received skeletonised grafts. Optimal wound management was pursued in all patients. A new four-grade classification for SWC was developed. Incidence and grade of SWC as well as overall survival were assessed.
Sternal wound complications (SWC) are a rare but potentially life-threatening complication after coronary artery bypass grafting (CABG) surgery. Especially the use of bilateral IMA (BIMA) grafts as opposed to single IMA (SIMA) grafts is associated with an increased risk of SWC. Skeletonised harvesting has been proposed to reduce this risk. The purpose of this study was to retrospectively investigate the effect of skeletonisation on SWC after off-pump coronary artery bypass grafting (OPCAB) in a centre with a high volume of off-pump procedures and high frequencies of BIMA. From January 2010 to November 2016, 1900 consecutive patients underwent OPCAB surgery at the University Hospitals of Leuven. The first group (n = 1487) received non-skeletonised IMA grafts, whereas the second group (n = 413) received skeletonised grafts. Optimal wound management was pursued in all patients. A new four-grade classification for SWC was developed. Incidence and grade of SWC as well as overall survival were assessed.
a Cochrane review concluded that BIS within 40 to 60 may improve anaesthetic delivery and postoperative recovery from relatively deep anaesthesia, and more important that BIS-guided anaesthesia significantly reduces the incidence of intraoperative recall in surgical patients with high risk of awareness (ex. TIVA) [Punjasawadwong et al. Cochrane Database Syst Rev. 4: CD003843, 2007]. The largest study in Cochrane was Myles et al. (2463 patients), the second-largest was only 268 patients. Cochrane did not review Avidan (see below), which was published later.. Myles et al. conducted a randomized, double blind trial of 2463 "high risk" patients (caesarean section, high-risk cardiac surgery [EF ,30%, cardiac index ,2·1 L/min per m2, severe aortic stenosis, pulmonary hypertension, or undergoing off-pump coronary artery bypass graft surgery], acute trauma with hypovolaemia, rigid bronchoscopy, significant impairment of cardiovascular status and expected intraoperative hypotension requiring treatment, ...
OBJECTIVE:Effective antiplatelet therapy may decrease the risk of complications following off-pump coronary artery bypass surgery (CABG). We prospectively evaluated the safety and early efficacy of a combined regimen of clopidogrel and aspirin starting immediately after off-pump CABG. METHODS: One hundred thirty-five consecutive off-pump CABG patients received clopidogrel (75 mg/day) and ...
Coronary artery bypass grafting (CABG) using in situ skeletonized arterial conduits with an off-pump technique is a high quality and minimally invasive procedure. The internal thoracic artery (ITA) is the most reliable conduit as grafting the left anterior descending artery and circumflex arteries with bilateral ITAs leads to better long-term patient outcomes. In this study, we demonstrated the feasibility and usefulness of off-pump coronary artery bypass grafting surgery using bilateral ITAs. A total of 217 consecutive CABG cases using skeletonized ITA grafts were studied and they were divided into 2 groups are using unilateral ITA (UITA, n 104) and the other using bilateral ITA (BITA, n 113). OPCAB was completed in 94% (98/104) in the UITA group and in 99% (112/113) in the BITA group. The mean number of distal anastomoses per patient was 3.02 in the UITA group and 3.63 in the BITA group. The ITAs were used in situ in 100% (104 ITAs) in the UITA group and in 96% (217 ITAs) in the BITA group. ...
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Patients assigned to off-pump coronary artery bypass grafting (CABG) have a lower risk of acute kidney injury (AKI) but no reduction in the rate of reduced kidney function 1 year later, reports a study in the Journal of the American Medical Association.
Over time, off-pump bypass surgery grafts may fail. This eMedTV resource discusses graft failure and off-pump bypass surgery, including how long grafts typically last and tips that can help delay graft failure after surgery.
AIMS: The benefits of off-pump coronary artery bypass (OPCAB) continue to be debated, in part due to the fact that pooled effects fail to consider differences in trial and patient characteristics. We sought to analyse the contemporary evidence for OPCAB vs. conventional coronary artery bypass (CCAB), incorporating recent larger trials, and adjusting for differences in trials using a technique known as meta-regression. METHODS AND RESULTS: We systematically reviewed MEDLINE, EMBASE, and the Cochrane database for published and unpublished randomized trials of OPCAB vs ...
Off pump vs on pump CABG. On pump CABG is the conventional method in which heart is arrested using potassium rich cardioplegia solution and the heart lung machine takes over the circulatory and gas exchange functions of the body. In off pump CABG, heart is fixed using suction devices and it continues to beat while bypass grafting is done. But the procedure is technically more demanding for surgical skill and potential risk of incomplete revascularization may occur. The theoretical advantages of off pump CABG are the reduction of systemic inflammatory state related to cardiopulmonary bypass, microemboli, increased permeability of blood brain barrier and aortic manipulation during cross clamping and cannulation. In spite of these theoretical advantages, one study showed that number of off pump CABG in United States declined from a peak level of 23% 2002 to 17% in 2012 [1]. According to that report, a minority of surgeons and centres do perform off pump CABG in most of their patients. In a comment ...
Click the title to purchase the article.. Background:. "Cardiac surgery often causes ischemia and development of a systemic inflammatory response syndrome, which impairs vascular barrier function, normally maintained by the endothelial cell line and the endothelial glycocalyx (EG). The EG normally covers and protects healthy endothelial cells throughout the vasculature. The aim of the present study was to assess the disruption of the cellular part of the microvascular barrier by determining parameters of endothelial cell activation known to influence and reflect cell-cell junctional integrity. Particular attention was placed on angiopoietins and their important effects on endothelial gap junctions. Furthermore, comparative measurements were undertaken in patients undergoing on- and off-pump cardiac surgery, the latter group presumably experiencing less ischemic stress."1. ...
Hybrid coronary revascularization is a planned combination of minimally invasive, off-pump coronary artery bypass grafting and percutaneous coronary intervention employed together to treat patients...
Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury,transfusion requirements, and length of stay: a single blind ...
Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury,transfusion requirements, and length of stay: a single blind ...
A hybrid procedure combining off-pump CABG and transaortic TAVR appears feasible as a treatment approach for select patients with complex coronary disease and severe aortic stenosis, a small case series suggests.. Over a 10-month period, operators performed the hybrid procedure in four men, all of whom had uneventful recoveries and remained complication-free through 6 months, Imthiaz Manoly, FRCS (C-Th) (Central Manchester University Hospitals Foundation Trust, England), and colleagues report in a study published online July 12, 2016, ahead of print in Catheterization and Cardiovascular Interventions. One patient died of a noncardiac cause (community-acquired pneumonia) at 8 months.. The remaining three patients-and another two not included in the paper-are currently doing well, Manoly told TCTMD.. "For patients who are deemed high risk just because of the technical challenge or a few comorbid factors, we should definitely consider transaortic TAVI and off-pump CABG," he said, noting that not ...
Lewes, DE -- 12/29/2017 -- CPB is also used in heart valve replacement and repair procedures, repair of septal and congenital heart defects and transplants. However, for the purposes of this report, this chapter analyzes the use of CPB specifically in ONCAB procedures. During an ONCAB procedure, the patients heart is stopped temporarily while surgeons…
Mitral valve repair and replacement, atrial fibrillation ablation and tricuspid repair, total arterial off-pump coronary artery bypass grafting, poor left ventricle function and ischaemic MR, thoracic surgery, clinical research ...
Mitral valve repair and replacement, atrial fibrillation ablation and tricuspid repair, total arterial off-pump coronary artery bypass grafting, poor left ventricle function and ischaemic MR, thoracic surgery, clinical research ...
Karbing DS, Kjærgaard S, Andreassen S, Espersen K, Rees SE. Minimal model quantification of pulmonary gas exchanges in intensive care patients. Med Eng Phys. 2011 Mar;33(2):240-8.. S.E Rees, S Kjærgaard, S Andreassen, G. Hedenstierna. Reproduction of inert gas and oxygenation data - a comparison of the MIGET and a simple model of pulmonary gas exchange. Intensive Care Medicine 2010, 36:2117-2124.. D.S Karbing, S Kjaergaard, B.W Smith, K Espersen, C Allerod, S Andreassen, S.E Rees. Variation in the PaO2/FiO2 ratio with FiO2: Mathematical and experimental description, and clinical relevance. Critical Care. 2007 ; Vol. 11, No. 6.. B.S Rasmussen, H Laugesen, J Sollid, J Grønlund, S.E Rees, E Toft, J Gjedsted, C Dethlefsen, E Tønnesen. Oxygenation and release of inflammatory mediators after off-pump compared to after on-pump coronary artery bypass surgery. Acta Anaesthesiologica Scandinavica, 2007, 51(9):1202-10.. S.E Rees, S Kjærgaard, S Andreassen, G. Hedenstierna. Reproduction of MIGET ...
BACKGROUND: There is a concern that revascularization using bilateral internal thoracic arteries (ITA) as a composite graft may not supply sufficient blood flow to a wider area of myocardium when compared with grafting using bilateral in situ ITAs. METHODS: One-hundred three patients who underwent off-pump coronary artery bypass using bilateral ITAs for revascularization of the left coronary system were studied prospectively. Bilateral ITAs were used as in situ grafts in 49 patients (group 1) and as a Y-composite graft in 54 patients (group 2). Resting and stress myocardial single-photon emission computed tomography (SPECT) was performed preoperatively and 3 months postoperatively. Myocardial perfusion was automatically quantified and expressed as a percentage of the maximal uptake. The left coronary territory was divided into 16 segments. A total of 379 segments (154 segments in group 1; 225 segments in group 2) that indicated decreased stress perfusion preoperatively were included in this ...
A sensitive and robust LC-MS/MS method was developed to quantify basal adenosine concentrations in human plasma of patients undergoing on-pump coronary artery bypass grafting (CABG) surgery. A strong cation exchange (SCX) monolithic cartridge was used to enrich analyte, improve robustness, and reduce biological complexity. A simple modifier-free mobile phase was employed to improve sensitivity and reproducibility. This method exhibits consistent precision and accuracy, and the RSDs or REs of all the intraday and interday determinations were within 10%. The calibration curve was linear across the examined dynamic range from 1nM to 500nM (r(2)=0.996). LOD and LOQ were determined to be 0.257nM and 0.857nM respectively, while LLOQ was below 10nM. This method was used to monitor changes of adenosine levels in patient plasma drawn intraoperatively during on-pump CABG surgery. The analysis of 84 patients revealed that the mean concentration of adenosine in coronary sinus plasma after cardiopulmonary ...
Nausea, vomiting, and minor bleeding are some of the common complications of off-pump bypass surgery. This eMedTV Web page takes a closer look at other complications that can occur and includes a link to more detailed information.
UC San Diego Health physicians and researchers are on the front lines of fighting heart and vascular diseases - at the patients bedsides, in the research lab, and in our community. The technologies, techniques and treatments we develop are setting standards in DestinationCare cardiac and stroke care. Our heart center optimizes both inpatient and outpatient cardiovascular care in a supportive environment attuned to your individual needs and situation.. UC San Diego Health was the regions first comprehensive heart center and one of the nations first comprehensive stroke centers. We remains a premier destination for managing and treating cardiovascular disease and caring for all types of stroke patients. With expertise in cardiology, cardiothoracic surgery, neurology, cardiac imaging, vascular surgery and numerous other specialties, we are able to provide services available only at the top health systems, such as off-pump coronary artery bypass (OPCAB) and minimally invasive valve replacements. ...
Thus, let-7 family miRNA may potentially provide novel targets for the sildenafil citrate 100mg pills development of therapeutic strategies against OS. A 54-year-old woman presented with acute pulmonary edema with intractable hypertension and a history of lower limb claudication. Type I and type II interferons upregulate functional type I interleukin-1 receptor in a human fibroblast cell line TIG-1. We found significant racial susceptibility to drug-induced QT prolongation in this large urban study of acute overdoses. Our results indicate that administration of carprofen prior to surgery was effective in improving peri-operative analgesia in dogs undergoing TPLO.. The fundamental mechanism proposed to explain surface-enhanced Raman scattering (SERS) relies on electromagnetic field enhancement at optical frequencies. Cross-validation of this model with other TBI populations is recommended. Single transpulmonary thermodilution in off-pump coronary artery bypass sildenafil citrate 100mg tab ...
CHICAGOPatients who underwent either on-pump or off-pump CABG surgery had similar outcomes at 30 days, according to a late breaking clinical trial presented March 26 at the American College of Cardiologys 61st scientific session. But with either procedure, operator experience was critical to success, and the results didnt rule out potential differences in long-term outcomes, said Andre Lamy, MD, of the Population Health Research Institute at McMaster University in Hamilton, Canada.
... regularly. I post this paper just in case anybody needs to use it as an argument supporting the vascular treatment of MS patients. Off-pump coronary surgery in a patient with multiple sclerosis. ...
by Physicians Weekly , Aug 2, 2012. Although the mortality rate associated with CABG has been declining, research suggests that patients who undergo these procedures are increasingly older and sicker. Risk factors for complications after CABG are high, and adverse neurologic outcomes (eg, stroke and cognitive decline) remain a major concern. Efforts to reduce post-CABG-related neurologic events have been hindered by an incomplete understanding of the pathophysiology of these events. One of the justifications for developing off-pump CABG was the hope that rates of embolization, and therefore stroke, would be lower than those experienced with on-pump surgery. However, a number of large prospective ran-domized trials have failed to show a significant difference in rates of post-surgical stroke between on- and off-pump bypass. In light of these findings, strategies to reduce the incidence of adverse post-CABG neurologic and cognitive outcomes should focus more on patient-related risk factors rather ...
by Physicians Weekly , Aug 2, 2012. Although the mortality rate associated with CABG has been declining, research suggests that patients who undergo these procedures are increasingly older and sicker. Risk factors for complications after CABG are high, and adverse neurologic outcomes (eg, stroke and cognitive decline) remain a major concern. Efforts to reduce post-CABG-related neurologic events have been hindered by an incomplete understanding of the pathophysiology of these events. One of the justifications for developing off-pump CABG was the hope that rates of embolization, and therefore stroke, would be lower than those experienced with on-pump surgery. However, a number of large prospective ran-domized trials have failed to show a significant difference in rates of post-surgical stroke between on- and off-pump bypass. In light of these findings, strategies to reduce the incidence of adverse post-CABG neurologic and cognitive outcomes should focus more on patient-related risk factors rather ...
34)高度低左心機能・重症多枝病変に対し有茎三本動脈グラフトによるoff-pump CABG(OPCAB)を施行した一治験例 (2003 ...
Some of the issues to be considered in the evaluation of OPCAB are Safety, Cost, Adequacy of revascularisation, patency of the grafts and long-term outcome. There is a surfeit of reports in current literature about OPCAB and the above issues will be answered by gleaning at a few of them. Most of these reports are retrospective non-randomised observational studies. The findings in the earlier phase of this operation are not comparable to the situation at present because OPCAB performed in the beginning of this era is a totally different operation compared to what is practised at present. The state of the art stabilisers have made this operation very much easier, safer and reproducible by any surgeon with average skills. So I will restrict this analysis of papers to those published in the last 4 years.. Iaco from the Calafiore group in Italy46 reported in 1999 their experience comparing 472 cases off-pump with 290 on-pump cases and concluded that there was no difference in primary endpoints ...