Off-pump versus on-pump coronary artery bypass grafting.
Coronary artery bypass grafting (CABG) remains the preferred treatment in patients with complex coronary artery disease. However, whether the procedure should be performed with or without the use of cardiopulmonary bypass, referred to as off-pump and on-pump CABG, is still up for debate. Intuitively, avoidance of cardiopulmonary bypass seems beneficial as the systemic inflammatory response from extracorporeal circulation is omitted, but no single randomized trial has been able to prove off-pump CABG superior to on-pump CABG as regards the hard outcomes death, stroke or myocardial infarction. In contrast, off-pump CABG is technically more challenging and may be associated with increased risk of incomplete revascularization. The purpose of the review is to summarize the current literature comparing outcomes of off-pump versus on-pump coronary artery bypass surgery.
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark, chm@rh.regionh.dk.
Christian H
CH
Møller
Daniel A
DA
Steinbrüchel
D058186:Acute Kidney Injury / Q000209:etiology; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D003324:Coronary Artery Disease / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology