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Bernhard Winkler, Paul P Heinisch, Brigitta Gahl, Soheila Aghlmandi, Hans Jörg Jenni, Thierry P Carrel
The pathophysiologic side effects of cardiopulmonary bypass have already been identified. Minimally invasive extracorporeal circulation technologies (MiECT) and off-pump coronary artery bypass graft surgery (OPCABG) aim to reduce these problems. This metaanalysis provides a comparison of MiECT and OPCABG in randomized and observational studies. A fully probabilistic, Bayesian approach of primary and secondary endpoints was conducted. MiECT does not give inferior results when compared with OPCABG. However, there is a trend to borderline significantly higher blood loss in this group in randomized controlled trials...
October 22, 2016: Annals of Thoracic Surgery
T S Liu, B T Chen, R Dong, Y Li, Y Zhao, K Hua
Objective: To discuss the clinical safety and efficacy about off-pump coronary artery bypass grafting (OPCABG) in octogenarians. Methods: From June 2005 to July 2014, 252 patients (male 208, female 44, with a mean age of 81.7 years old) underwent OPCABG in Beijing Anzhen Hospital who were aged 80 years or older were enrolled. Results: Eight (3.2%) patients were diagnosed as single vessel coronary artery disease (CAD), 29 cases (11.5%) were diagnosed as bifurcation vessel CAD, and 215 cases (85.3%) were multivessel CAD...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Zhe Song, Paul Fu, Mingying Chen, Qi Bi
OBJECTIVE: To investigate the relationship between an abnormal CT perfusion scan and postoperative cognitive dysfunction, as measured by changes in MoCA and MMSE scores, after off-pump coronary artery bypass grafting (OPCABG). METHODS: Eight hundred and thirteen patients were selected who underwent OPCABG between August 2010 and September 2013. Cognitive function was assessed before operation and at seven days post-op. CT perfusion scan was obtained preoperatively and was used to divide patients into two groups: abnormal perfusion and normal perfusion groups...
June 2016: Neurological Research
Filippo Sanfilippo, Federica Chiarenza, Cesare Cassisi, Cristina Santonocito, Theodoros Tsoutsouras, Marialena Trivella, Stephen Gerry, Marinella Astuto, Shane George, David P Taggart
OBJECTIVE: Hyperlactatemia and base deficit (BD) are markers of adverse outcome after cardiac surgery, and their derangement can be influenced by the use of extracorporeal circulation. The authors hypothesized a better postoperative metabolic profile in off-pump coronary artery bypass grafting (OPCABG) compared with "on-pump" coronary artery bypass grafting (ONCABG). DESIGN: This was a retrospective study, with consecutive data collected for 1 year from electronic medical records...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
Savvas Lampridis, Man Chi Lau, Peter Mhandu, Haralabos Parissis
A 76-year-old male presented with angina and a large retrosternal goitre causing marked dyspnoea. Coronary angiography revealed triple vessel disease and moderately impaired left ventricular function. CT imaging demonstrated a substantial multinodular goitre extending into the posterior mediastinum to the level of the carina, with associated compression of the trachea and oesophagus. Preoperative thyroid function tests showed euthyroid state. The patient subsequently underwent off-pump coronary artery bypass grafting (OPCABG) ×2 with concomitant total thyroidectomy...
May 2016: Journal of Thoracic Disease
Deepak Prakash Borde, Balaji Asegaonkar, Pramod Apsingekar, Sujeet Khade, Savni Futane, Bapu Khodve, Mahesh Kedar, Anand Deodhar, Unmesh Takalkar, Antony George, Shreedhar Joshi
CONTEXT: Left ventricle diastolic dysfunction (LVDD) is gaining importance as useful marker of mortality and morbidity in cardiac surgical patients. Different algorithms have been proposed for the intraoperative grading of DD. Knowledge of the particular grade of DD has clinical implications with the potential to modify therapy, but there is a paucity of literature on the role of diastolic function evaluation during off-pump coronary artery bypass grafting (OPCABG) surgery. AIMS: The aim of this study was to monitor changes in LVDD using simplified algorithm proposed by Swaminathan et al...
April 2016: Annals of Cardiac Anaesthesia
Paula Carmona, Federico Paredes, Eva Mateo, Armando V Mena-Durán, Fernando Hornero, Juan Martínez-León
OBJECTIVES: We aim to describe our experience in coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass by comparing intraoperative and postoperative outcomes. METHODS: From January 1993 to June 2013, 3097 patients underwent consecutive emergency and scheduled CABG surgery. A total of 1770 patients underwent on-pump CABG (ONCABG) and 1327 off-pump CABG (OPCABG). A propensity score matching was performed to identify appropriate matched-pair patients; univariable and multivariable logistic regression analyses were performed to assess significant predictors of hospital and 30-day morbidity and mortality composite end-points...
May 2016: Interactive Cardiovascular and Thoracic Surgery
Andrew Brazier, Imthiaz Manoly, Doug Fraser, Ragheb Hasan
No abstract text is available yet for this article.
December 16, 2015: Journal of Cardiothoracic Surgery
Jinwei Zhang, Fangjiong Huang, Jinfei Yang, Qiang Wu, Yue Liu, Yuan Zhou, Yixi Zou, Enjun Zhu
OBJECTIVE: To evaluate the impact of preoperative dual antiplatelet therapy of aspirin and clopidogrel on perioperative blood loss and blood transfusion requirements. METHODS: A total of 60 patients underwent off-pump coronary artery bypass grafting (OPCABG) performed by the same surgeons. And they were assigned to receive dual antiplatelet therapy of aspirin and clopidogrel (group AC, n = 30) and discontinue antiplatelet therapy more than 5 days before surgery (group control, n = 30)...
June 23, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Aliaksandr Ziankou, Yuri Ostrovsky
OBJECTIVE: To carry out the comparative analysis of early and midterm results of no-touch aorta multivessel small thoracotomy coronary artery bypass grafting (MVST CABG), conventional off-pump (OPCABG) and on-pump CABG (ONCABG). METHODS: From 2007 to 2014, 537 consecutive patients underwent CABG by the same surgeon. Propensity score computer matching was performed, and a total of 453 patients were successfully matched in 3 groups of 151 patients. RESULTS: Significant differences were found in the intraoperative blood loss: 220 (180; 300) mL in MVST CABG versus 400 (300; 550) mL in OPCABG vs 350 (250; 435) mL in ONCABG group; first 24-hour postoperative blood loss: 170 (100; 280), 320 (200; 470), and 380 (200; 500) mL, respectively; operation time: 352...
July 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Dominic A Emerson, Conor F Hynes, Michael D Greenberg, Gregory D Trachiotis
OBJECTIVE: The management of acute coronary syndrome (ACS) has evolved dramatically over the last 50 years. Currently, management includes a multidisciplinary approach potentially including catheter-based therapy, surgery, or purely medical management. Where surgical therapy is indicated, data regarding long-term outcomes are limited. In particular, little data exist regarding on-pump (conventional coronary artery bypass grafting, cCABG) versus off-pump (OPCABG) outcomes for this group...
May 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Anil Karlekar, Saswata Bharati, Ravindra Saxena, Kanchan Mehta
BACKGROUND: Laser therapy, for its established analgesic properties with minimal side effects, has been used for the treatment of chronic pain. However, it has not been used for the treatment of acute postoperative pain. This pilot study was designed to assess the feasibility and efficacy of Class IV laser on postoperative pain relief following off-pump coronary artery bypass graft (OPCABG) surgery, as a component of multimodal analgesia (MMA) technique. METHODS: This open observational prospective study comprised of 100 adult patients (84 male, 16 female) who underwent OPCABG through sternotomy...
July 2015: Annals of Cardiac Anaesthesia
Marc Bienz, David Drullinsky, Louis-Mathieu Stevens, David Bracco, Nicolas Noiseux
OBJECTIVES: The use of cardiopulmonary bypass (CPB) during coronary artery bypass graft surgery (CABG) is associated with a systemic inflammatory response, resulting in altered microcirculation. The aim of this study was to evaluate whether beating heart surgery can preserve the microcirculation. METHODS: Sublingual microcirculation was characterized by a Sidestream Darkfield Imaging Microscope during off-pump (OPCABG) and on-pump (ONCABG) surgery. Microcirculatory parameters were evaluated during eight precise perioperative time points...
April 2016: Perfusion
Ana Barisin, Zdenko Sonicki, Josip Vincelj, Zeljko Sutlic, Stjepan Barisin
OBJECTIVES: The aim of this study was to assess the recovery of regional myocardial function of the left-ventricular septal wall and the septal site of the mitral valve (MV) annulus by tissue Doppler imaging (TDI). METHODS: In 63 (32 diabetic and 31 control) patients having off-pump coronary artery bypass grafting (OPCABG), including the left internal mammary artery (LIMA) and the left anterior descending coronary artery (LAD), TDI measurements were performed before operation (baseline), 5 min after LIMA-LAD revascularization (early reperfusion) and after completion of all anastomoses (after revascularization)...
2015: Cardiology
Fang-Bin Hu, Lian-Qun Cui
BACKGROUND: Hybrid coronary revascularization (HCR) and off-pump coronary artery bypass grafting (OPCABG) are both feasible, less invasive techniques for coronary revascularization. Although both techniques utilize the left internal mammary artery to left anterior descending artery graft, HCR uses drug-eluting stents instead of saphenous vein bypass. It remains unclear whether HCR is equal to, better or worse than OPCABG. METHODS AND RESULTS: A meta-analysis was carried out using a random-effects model...
September 2015: Coronary Artery Disease
Giovanni Concistrè, Angelo Maria Dell'Aquila, Alessandro Piccardo, Stefano Pansini, Raffaele Gargiulo, Alina Gallo, Bruno Merlanti, Giancarlo Passerone, Tommaso Regesta
AIM: To compair biological and clinical outcomes after off-pump coronary artery bypass grafting (OPCABG) and conventional on-pump coronary artery bypass grafting (CCABG) in the elderly with left ventricular (LV) dysfunction. MATERIAL OF STUDY: We retrospectively reviewed 90 consecutive patients aged more than 75 years with preoperative left ventricular ejection fraction (LVEF) < 50% who underwent isolated coronary artery bypass grafting at our Institution between January 2000 and July 2009...
March 2015: Annali Italiani di Chirurgia
Baolei Xu, Qiubo Qiao, Mingying Chen, Radhika Rastogi, Di Luo, Qi Bi
OBJECTIVE: To investigate risk factors for neurological complications after off-pump coronary artery bypass grafting (OPCABG). METHODS: We reviewed the cases of 813 patients who underwent OPCABG between August 2010 and September 2013.Data from preoperative 320 dynamic volume computed tomography (CT), CT angiography (CTA), CTA perfusion, and cerebrovascular function examinations were assessed. Neural function was assessed before and 7 days after operation, and patients were assigned to either the neurological complications or non-neurological complications group...
May 2015: Neurological Research
Renteng Zhang, Hui Jiang, Huishan Wang, Zhonglu Yang, Nan Zhou, Hao Gao
OBJECTIVE:  To investigate the perioperative features of aged patients undergoing off-pump coronary artery bypass grafting (OPCABG) surgery, and identify the perioperative effect of advanced age on OPCABG. METHOD:  A total of 61 aged patients and 585 younger patients from August 2013 to June 2014 were enrolled in this study. The perioperative features were summarized, and the effects of advanced age on intraoperative variables, as well as the postoperative complications were identified using logistic regression analysis...
April 2016: Thoracic and Cardiovascular Surgeon
Dominic A Emerson, Conor F Hynes, Gregory D Trachiotis
OBJECTIVE: Recently published data indicate that outcomes for off-pump coronary artery bypass grafting (OPCABG) may be inferior to conventional CABG (cCABG) within the Veteran population, but this has been only partly addressed within high-volume off-pump centers. Here, we seek to examine the long-term outcomes for these patients within the Veteran population at a single institution well experienced with OPCABG. METHODS: With the use of a preexisting in-house database, all patients who had undergone isolated CABG from 2000 to 2011 (n = 1125) were identified...
March 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Salah E Altarabsheh, Salil V Deo, Abeer M Rababa'h, Ju Yong Lim, Yang Hyun Cho, Vikas Sharma, Sung Ho Jung, Euisoo Shin, Alan H Markowitz, Soon J Park
BACKGROUND: Data comparing results of off-pump and conventional operations in octogenarians is very limited. Thus we chose to compare early adverse events between off-pump coronary artery bypass grafting (OPCABG) and on-pump CABG (ONCABG) in patients older than 80 years. METHODS: Systematic review of multiple databases was performed to obtain original studies fulfilling search criteria. End points--early mortality, stroke, respiratory failure, atrial fibrillation, and myocardial infarction--were compared between these cohorts...
May 2015: Annals of Thoracic Surgery
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