Systematic organ protection in coronary artery surgery with or without cardiopulmonary bypass.
Coronary artery bypass grafting with cardiopulmonary bypass (CPB) is known to be associated with a systemic inflammatory response, which contributes to the development of postoperative complications including multiple organ dysfunction. Off-pump coronary surgery has been shown to attenuate the inflammatory injury compared to the conventional approach, thereby reducing the incidence of postoperative cardiopulmonary, renal, or neurological dysfunction. It is believed that off-pump experience may greatly impact on improving the outcome of coronary surgery in certain high-risk patients. Moreover, a better understanding of the underlying mechanism would also help to improve our current CPB management. Accumulating evidence to date indicates that a balance between pro- and antiinflammatory responses is crucial in limiting the extent of such systemic inflammatory injury following surgical myocardial revascularization.
Wan
Song
S
Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, People's Republic of China, Shatin, Hong Kong. swan@cuhk.edu.hk
Yim
Anthony P C
AP
Ng
Calvin S H
CS
Arifi
Ahmed A
AA
D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D012307:Risk Factors; D014022:Tissue Survival / Q000502:physiology*