title: Anaortic, total-arterial, off-pump coronary artery bypass surgery: why bother?
abstract: Coronary artery bypass grafting (CABG) remains the standard of care for multi-vessel coronary disease. However, the increased rate of peri-operative stroke reported after surgery compared to percutaneous coronary intervention (PCI) remains of concern. Anaortic, total-arterial, off-pump coronary artery bypass (OPCAB) grafting is a technique that offers the main advantages of surgical revascularisation with a rate of stroke that is equivalent to that of PCI. Some recent trials comparing conventional on-pump CABG with OPCAB have questioned the efficacy of the off-pump technique - these are most often performed with manipulation of the ascending aorta. We review the potential benefits of the anaortic, total-arterial OPCAB technique to explain why it is being employed by an increasing number of surgeons.
authors.affiliation: Cardiothoracic Surgical Unit, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: J J B
authors.initials: JJ
authors.lastname: Edelman
authors.forename: A G
authors.initials: AG
authors.lastname: Sherrah
authors.forename: M K
authors.initials: MK
authors.lastname: Wilson
authors.forename: P G
authors.initials: PG
authors.lastname: Bannon
authors.forename: R J
authors.initials: RJ
authors.lastname: Brereton
authors.forename: D E
authors.initials: DE
authors.lastname: Ross
authors.forename: M P
authors.initials: MP
authors.lastname: Vallely
mesh_terms: D001011:Aorta / Q000601:surgery; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008323:Mammary Arteries / Q000637:transplantation; D017534:Radial Artery / Q000637:transplantation; D020521:Stroke / Q000209:etiology*; D014654:Vascular Patency