Medical science monitor : international medical journal of experimental and clinical research
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Review
Off-pump coronary artery bypass grafting: simple concept but potentially sublime scientific value.
This review discusses the available scientific evidence of the physiological changes and clinical outcomes with off-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting is more technically demanding, and its prognostic advantage has not been clearly elucidated. This paper examines the evolution of off-pump coronary artery bypass grafting and the technical challenges of 'bypassing' the cardiopulmonary bypass machine. ⋯ A rapid advance in beating heart surgery technology occurred in the past 5 yrs enabling off-pump multivessel coronary bypass grafting to be performed with relative technical ease, thereby offsetting the propensity to incomplete revascularization which can be a major setback. The clinical outcome of patients with varying surgical risks who have off-pump coronary artery bypass grafting are comparable to those who have surgical revascularization with cardiopulmonary bypass. With the technical challenges of off-pump coronary bypass grafting surmounted, the simple concept of avoiding cardiopulmonary bypass can yield impressive results that would help to establish the routine use of this technique for myocardial revascularization.