[Off-pump coronary artery bypass].
Development of beating heart coronary artery bypass surgery was possible since introduction of heart stabilizing instruments in mid-90's.
To summarize available evidence of benefits of beating heart coronary artery bypass surgery in comparison with use of cardiopulmonary bypass during surgery. Methods of heart stabilization during operation without cardiopulmonary bypass allow to performing complete revascularization with lower degree of myocardial damage. The main advantage of beating heart coronary bypass surgery is excluding systemic inflammatory response following cardiopulmonary bypass use. And therefore less incident of renal failure, clotting disturbances, respiratory complications. There is lower incidence of microthrombotic formation and central nervous system complications. Early mortality is significantly lower and it is safer to operate on high risk patients (over 75 years old, female, with acute coronary syndrome, ascending aorta arteriosclerosis).


CONCLUSIONS
The technique of beating heart coronary artery bypass surgery reduces risk of central nervous system complications, renal failure, respiratory problems and coagulation disturbances. The complete revascularisation is possible. This technique is available to enlarging group of patients, especially the high perioperative risk patients.
Chojecki
Łukasz
Ł
Wojskowy Instytut Medyczny w Warszawie, Kliniczny Oddział Kardiochirurgii CSK MON. lukchoj@mediclub.pl
Hendzel
Piotr
P
Gryszko
Leszek
L
Szałański
Przemysław
P
Szczawiński
Wojciech
W
Rymsza
Artur
A
Kostyra
Grzegorz
G
Hendzel
Tomasz
T
D002315:Cardiopulmonary Bypass; D002986:Clinical Trials as Topic; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome