[Is coronary artery bypass grafting under extracorporeal circulation the only technic that assures complete myocardial revascularization? Pros and cons].
Like other technical advances in medicine, the initial phase of rejection of off-pump revascularization has given way to its acceptance with some limitations. Today's main concern is whether the technique can be safely applied to access all coronary arteries, specially the postero-lateral vessels of the heart. We believe that off-pump CABG has proven to be an excellent alternative to the standard revascularization techniques avoiding the risks and complications of cardiopulmonary bypass (CPB). It can be applied to any case with minimal incidence of conversions thus avoiding the complications of CPB. In this debate we describe our technique, discuss our experience with complete myocardial revascularization, and suggest that the CPB machine should be a readily available tool for more complex cases rather than the current concept that it is an indispensable element for myocardial revascularization.
Soltoski
P R
PR
Division of Cardiothoracic Surgery, VAMC, Kaleida Health System and State University of New York at Buffalo, Buffalo, NY, USA.
Panos
A L
AL
Bergsland
J
J
Salerno
T A
TA
D001026:Coronary Artery Bypass / Q000295:instrumentation / Q000379:methods*; D005112:Extracorporeal Circulation / Q000295:instrumentation / Q000379:methods*; D006801:Humans