Off-pump coronary surgery: where do we stand in 2010?
OBJECTIVE
In this review, we will highlight recent studies comparing off-pump coronary artery bypass surgery with traditional on-pump coronary artery bypass surgery.


RESULTS
Current literature comparing off-pump vs. on-pump coronary artery bypass has failed to demonstrate the superiority of one technique over the other. Small prospective randomized controlled trials continue to show equivalent in-hospital outcomes and continue to raise concerns about vein graft patency and completeness of revascularization. Larger observational analyses are better powered to statistically compare in-hospital outcomes in both low and high-risk patients and in general have shown more favorable in-hospital outcomes and equivalent long-term outcomes with off-pump compared with on-pump coronary artery bypass.


CONCLUSIONS
Off-pump coronary artery bypass continues to be a useful technique for coronary revascularization. The benefits of off-pump techniques may be more apparent for patients at high risk for complications associated with cardiopulmonary bypass and aortic manipulation.
Halkos
Michael E
ME
Clinical Research Unit, Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Georgia 30308, USA.
Puskas
John D
JD
D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods* / Q000639:trends; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D012307:Risk Factors; D014481:United States; D014654:Vascular Patency