title: Myocardial revascularization without extracorporeal circulation; Why hasn't it convinced yet?
abstract: Extracorporeal circulation has led to a great development in cardiovascular surgery during the last five decades. Its time-proven efficacy and safety have made on-pump coronary artery bypass grafting (CABG) the gold standard method of surgical revascularization. However, coronary revascularization on cardiopulmonary bypass and the accompanying aortic manipulation are related to plenty of deleterious complications. Therefore, off-pump CABG surgery was established to avoid complications. Nevertheless, despite the initial enthusiasm on this technique, only 20% of myocardial revascularization procedures worldwide are performed off-pump. Not only are off-pump cardiac procedures more technically difficult but also they do not provide better results in terms of graft patency, completeness of revascularization, repeat revascularization requirement, cost, and quality of life. Completeness of revascularization and anastomotic quality should not be compromised to avoid cardiopulmonary bypass.
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital of Ioannina, School of Medicine, 45500 Ioannina, Greece.
authors.forename: Efstratios
authors.initials: E
authors.lastname: Apostolakis
authors.affiliation: Department of Cardiothoracic Surgery, General Hospital of Athens "Evangelismos", Athens, Greece.
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Papakonstantinou
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital of Patras, School of Medicine, Rion 26500, Patras, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Koniari
mesh_terms: D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D005112:Extracorporeal Circulation; D006801:Humans; D009204:Myocardial Revascularization / Q000379:methods*