Conversion and safety in off-pump coronary artery bypass: a system failure that needs re-emphasis.
Institution of cardiopulmonary bypass after commencement of "off-pump" coronary artery bypass surgery is known as conversion. This may be an emergency or elective process. The phenomenon of conversion, although widely reported, remains under-emphasized. Emergency conversion may lead to poorer patient outcomes and therefore warrants serious consideration. The rate of conversion may influence the results of randomized controlled trials, and be considered a surrogate performance indicator of surgical competence in off-pump coronary artery bypass. Several causes and predictors of conversion are reported in published literature. This article aims to examine the phenomenon of conversion in off-pump coronary artery bypass and proposes a framework for its prevention.
Department of Biosurgery and Surgical Technology, Imperial College London, St. Mary's and Hammersmith Hospital Campus, London, United Kingdom.
Dayal
D
Mukherjee
Kamran
K
Ahmed
Kamran
K
Baig
Vanash M
VM
Patel
Ara
A
Darzi
Thanos
T
Athanasiou
D000465:Algorithms; D002315:Cardiopulmonary Bypass / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003663:Decision Trees; D055317:Evidence-Based Practice; D006439:Hemodynamics; D006801:Humans; D007902:Length of Stay; D019300:Medical Errors / Q000517:prevention & control; D018579:Patient Selection; D011183:Postoperative Complications / Q000517:prevention & control*; D016896:Treatment Outcome