Coronary perfusion methods during off-pump coronary artery bypass: results of a randomized clinical trial

Vassiliades, Thomas A.; Nielsen, James L.; Lonquist, James L.

doi:10.1016/s0003-4975(02)03912-7

Cited by 32 publications

(9 citation statements)

References 16 publications

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“…Some surgeons employ active distal perfusion until completion of the proximal anastomoses. Vassiliades et al demonstrated the efficacy of latter methodology in a comparative study [24]. Patients were prospectively randomised to receive one of three OPCAB coronary perfusion treatments: (1) no coronary perfusion (NCP), (2) passive coronary perfusion (PCP) or (3) active coronary perfusion (ACP).…”

Section: Discussionmentioning

confidence: 99%

Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore☆

Thomas

Martinez

Woitek

et al. 2009

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore☆

Thomas

Martinez

Woitek

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…However, emerging evidence suggests that intraoperative myocardial protection in OPCAB can provide an added advantage [22,23]. Vassiliades, et al [24] compared active coronary perfusion using a perfusion pump, with passive perfusion by a cannula connected from the aorta to the graft, and no coronary perfusion, after the distal anastomosis in a randomized clinical trial. They found lower troponin I levels with active and passive coronary perfusion, but cardiac performance was better with active coronary perfusion.…”

Section: Myocardial Preservationmentioning

confidence: 99%

Re-engineering in OPCAB—A Vettath’s perspective

Vettath¹,

Ismail²,

Kannan³

2013

WJCD

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OPCAB (off pump coronary artery bypass) has become a preferred technique of coronary revascularization in India, and more so in the East. This technique was restarted by Buffalo and Bennetti who had published their results in 1985. Since then, there has been a great enthusiasm among coronary surgeons to develop and standardize this technique of CABG (coronary artery bypass grafting). In the late nineties, nearly all the coronary centers in India started performing this technique. But, by the early 2000, only a few surgeons continued this practice. Only those who could perform this OPCAB technique in nearly 100% of their patients continued this and the rest of them returned back to the conventional on pump CABG. To attain this result, we had to re-engineer our technique of anesthesia, surgical technique, stabilization, and positioning of the heart to enable us to perform OPCAB in all patients who needed CABG. We have analyzed our last 3000 patients operated by the same surgeon (Dr MPV), in the same center with the same team. As OPCAB was the only procedure performed for coronary revascularization, we have compared our first 1000 patients, with the second 2000 patients that underwent the procedure. Our technique and our results are presented.

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“…Vassiliades et al (38) prospectively randomized patients to receive one of three OPCAB coronary perfusion treatments. (1) no coronary perfusion (NCP), i.e.…”

Section: Myocardial Preservationmentioning

confidence: 99%

Deleterious effects of cardiopulmonary bypass in coronary artery surgery and scientific interpretation of off‐pump's logic

2006

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Cardiopulmonary bypass (CPB) has been suggested to be a cause of complex systemic inflammatory response that significantly contributes to several adverse postoperative complications. In the last few years, off-pump coronary artery bypass grafting (OPCAB) has gained widespread attention as an alternative technique to conventional on-pump coronary artery bypass grafting (ONCAB). However, a degree of uncertainty regarding the relative merits of ONCAB and OPCAB continues to be a significant issue. Surgeons supporting off-pump surgery, state that the avoidance of the CPB leads to significantly reduced myocardial ischemia-reperfusion injury, postoperative systemic inflammatory response and other biological derangements, a feature that may improve the clinical outcomes. However, perfection in perioperative care, surgical technique and methods of attenuating the untoward effects of CPB has resulted in better clinical outcome of ONCAB as well. Possible reasons of these controversial opinions are that high-quality studies have not comprehensively examined relevant patient outcomes and have enrolled a limited range of patients. Some studies may have been too small to detect clinically important differences in patient outcomes between these two modalities. We present a review of the available scientific interpretation of the literature on OPCAB with regard to safety, hemodynamic changes, inflammation, myocardial preservation and oxidative stress. We also sought to determine from different reported retrospective and randomized control studies, the initial and the long-term benefits of this approach, despite the substantial learning curve associated with OPCAB.

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Coronary perfusion methods during off-pump coronary artery bypass: results of a randomized clinical trial

Cited by 32 publications

References 16 publications

Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore☆

Off-pump coronary bypass grafting is safe and efficient in patients with left main disease and higher EuroScore☆

Re-engineering in OPCAB—A Vettath’s perspective

Deleterious effects of cardiopulmonary bypass in coronary artery surgery and scientific interpretation of off‐pump's logic

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