Beating-Heart Versus Conventional On-Pump Coronary Artery Bypass Grafting: A Meta-Analysis of Clinical Outcomes

Chaudhry, Umar; Harling, Leanne; Sepehripour, Amir H.; Stavridis, George; Kokotsakis, John; Ashrafian, Hutan; Athanasiou, Thanos

doi:10.1016/j.athoracsur.2015.05.057

Cited by 33 publications

(37 citation statements)

References 18 publications

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“…The results showed that PAD-CAB allowed for a significantly higher number of bypass grafts performed with greater revascularization and statistically insignificant differences in mortality and major cardiovascular adverse events. Similar findings were reported the year before by the same authors [22,23]. The author's (LES) experience with beating heart surgery-both OP-CAB and PAD-CAB-was initially developed in response to the challenges associated with CABG surgery in sick patients with weak hearts.…”

Section: Discussionsupporting

confidence: 68%

Pump-Assisted Beating-Heart Coronary Artery Bypass Grafting: The Pursuit of Perfection

Samuels¹,

Samuels²

2017

J Clin Exp Cardiolog

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Background: The techniques utilized to accomplish Coronary Artery Bypass Grafting (CABG) include the traditional use of cardiopulmonary bypass (CPB) with aortic cross-clamping and cardioplegic arrest to totally OffPump (i.e. OP-CAB) without CPB. The purpose of this report is to describe a hybrid approach-Pump-Assisted Direct CABG (PAD-CAB)--with the aid of CPB without aortic cross-clamping and cardioplegic arrest.

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Section: Discussionsupporting

confidence: 68%

Pump-Assisted Beating-Heart Coronary Artery Bypass Grafting: The Pursuit of Perfection

Samuels¹,

Samuels²

2017

J Clin Exp Cardiolog

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“…As the main source of enhanced oxidative stress and inflammatory response during CABG seems to be ECC using, several studies evaluating influence of on and – off pump operation on outcome were performed and advantages of beating heart techniques was confirmed in terms of early mortality [48]. Providing of on – pump CABG was reported as a predictive factor of low cardiac output syndrome [49] and perioperative myocardial infarct [50], although the results of large randomized trials did not confirm the significant superiority off- pump technique [51]. Also in high operative risk patients treated preventively with intra – aortic balloon pump there was no significant difference in perioperative mortality in comparison with control group [52].…”

Section: Discussionmentioning

confidence: 99%

Dynamic changes of paraoxonase 1 activity towards paroxon and phenyl acetate during coronary artery surgery

Wysocka

Cybulski

Berbeć

et al. 2017

BMC Cardiovasc Disord

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BackgroundSerum paraoxonase 1 (PON1), an enzyme associated with high – density lipoproteins (HDL) particles, inhibits the oxidation of serum lipoproteins and cell membranes. PON1 activity is lower in patients with atherosclerosis and in inflammatory diseases. The systemic inflammatory response provoked during cardiopulmonary bypass grafting may contribute to the development of postoperative complications. The aim of the present study was to estimate the dynamic changes in paraoxonase 1 (PON1) activity towards paraoxon and phenyl acetate during and after coronary artery surgery.MethodsTwenty six patients with coronary heart disease undergoing coronary artery bypass grafting (CABG) were enrolled into the study. Venous blood samples were obtained preoperatively, after aortic clumping, after the end of operation, at 6, 18, 30 and 48 h after operation. Paraoxonase activity was measured spectrophotometrically in 50 mM glycine/NaOH buffer (pH 10.5) containing 1.0 mM paraoxon, and 1.0 mM CaCl2. Arylesterase activity was measured in 20 mM TrisCl buffer (pH 8.0) containing 1 mM phenyl acetate and 1 mM CaCl2.ResultsPON1 activity toward paraoxon and phenyl acetate significantly decreased after aorta cross clumping and increased directly after operation. PON1 activity towards paraoxon in preoperative period and PON1 activity towards phenyl acetate in seventh stage of experiment tended to inversely correlate with the occurrence of postoperative complications.ConclusionThe paraoxonase 1 plasma activity is markedly reduced during CABG surgery.

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“…In recent years, as an alternative to both techniques, the on-pump beating-heart coronary artery bypass grafting (ONBHCAB) technique has gained acceptance in order to eliminate the harmful effects of cross-clamping, cardioplegia and unloading the heart, and it preserves both native coronary blood flow and cardiac output during surgery 5-7. Although a metaanalysis revealed better short-term outcomes and late survival rates following ONBHCAB compared with conventional CABG (CCAB),7 studies comparing the outcomes of ONBHCAB and OPCAB techniques in a similar patient population are lacking.…”

Section: Objectivesmentioning

confidence: 99%

“…Although a metaanalysis revealed better short-term outcomes and late survival rates following ONBHCAB compared with conventional CABG (CCAB),7 studies comparing the outcomes of ONBHCAB and OPCAB techniques in a similar patient population are lacking. Therefore we aimed to compare the short-term outcomes and long-term major adverse cardiovascular event (MACE)-free survival after ONBHCAB versus OPCAB in a matched population.…”

Section: Objectivesmentioning

confidence: 99%

A comparison of off- and on-pump beating-heart coronary artery bypass surgery on long-term cardiovascular events

Gürbüz

Kumtepe

Yolgösteren

et al. 2017

CVJA

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SummaryObjectiveOur aim was to compare short-term outcomes and long-term major adverse cardiovascular event (MACE)-free survival and independent predictors of long-term MACE after off-pump (OPCAB) versus on-pump beating-heart (ONBHCAB) coronary artery bypass grafting (CABG).MethodsWe retrospectively reviewed data of all consecutive patients who underwent elective CABG, performed by the same surgeon, from January 2003 to October 2009. A propensity score analysis was carried out to adjust for baseline characteristics and a total of 398 patients were included: ONBHCAB (n = 181), OPCAB (n = 217).ResultsOPCAB was associated with significantly shorter ventilation times (p < 0.001), intensive care unit stay (p < 0.001) and hospital stay (p < 0.001). The total blood loss was significantly more in the ONBHCAB group (p < 0.001), and accordingly, the number of transfused blood units was significantly lower in the OPCAB group (p < 0.001). Incidence of peri-operative renal complications were significantly higher in the ONBHCAB group (p = 0.004). The OPCAB group showed significantly lower long-term MACE-free survival (p = 0.029). The mean number of transfused blood units was the only independent predictor of MACE (HR: 1.218, 95% CI: 1.089–1.361; p = 0.001).ConclusionOPCAB provided better long-term MACE-free survival compared with ONBHCAB. Fewer units of blood transfused following OPCAB surgery may have been the main reason for this result.

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Beating-Heart Versus Conventional On-Pump Coronary Artery Bypass Grafting: A Meta-Analysis of Clinical Outcomes

Cited by 33 publications

References 18 publications

Pump-Assisted Beating-Heart Coronary Artery Bypass Grafting: The Pursuit of Perfection

Pump-Assisted Beating-Heart Coronary Artery Bypass Grafting: The Pursuit of Perfection

Dynamic changes of paraoxonase 1 activity towards paroxon and phenyl acetate during coronary artery surgery

A comparison of off- and on-pump beating-heart coronary artery bypass surgery on long-term cardiovascular events

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