Inflammatory response in on- versus off-pump myocardial revascularization: is ECC really the culprit?
A review of inflammatory mediators in on- versus off-pump surgery reveals that parameters of systemic inflammation differ quantitatively, not qualitatively between these approaches. Mediator system and cellular activation is observed after surgical trauma and following ischemia/reperfusion. Such activation is also modulated by genetic factors. The available literature does not permit definitive conclusions to be made on the advantages of off-pump surgery with respect to the systemic inflammatory response. The relationship between mediator systems and clinical course needs to be assessed in large patient populations to demonstrate to what extent off-pump surgery is more than just theoretically superior to on-pump surgery.
Börgermann
J
J
Department of Cardiac and Thoracic Surgery, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany. jochen.boergermann@t-online.de
Scheubel
R J
RJ
Simm
A
A
Silber
R E
RE
Friedrich
I
I
D003167:Complement Activation; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D016207:Cytokines / Q000378:metabolism*; D005112:Extracorporeal Circulation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007111:Immunity, Cellular / Q000502:physiology*; D007249:Inflammation; D017202:Myocardial Ischemia / Q000601:surgery*; D009204:Myocardial Revascularization; D018384:Oxidative Stress / Q000502:physiology*; D012307:Risk Factors
D016207:Cytokines