Off-pump versus on-pump coronary artery bypass grafting for ischaemic heart disease

Comparison of renal outcomes in off‐pump versus on‐pump coronary artery bypass grafting: A systematic review and meta‐analysis of randomized controlled trials

“…Despite the reduction in the incidence of AKI, OPCAB did not decrease the requirement of renal replacement therapy after cardiac surgery. This finding of our updated meta‐analysis is consistent with the results in previous published meta‐analyses on this topic . This result reflects that OPCAB reduces only mild to moderate AKI but not severe AKI requiring dialysis.…”

Comparison of renal outcomes in off‐pump versus on‐pump coronary artery bypass grafting: A systematic review and meta‐analysis of randomized controlled trials

“…Despite the reduction in the incidence of AKI, OPCAB did not decrease the requirement of renal replacement therapy after cardiac surgery. This finding of our updated meta‐analysis is consistent with the results in previous published meta‐analyses on this topic . This result reflects that OPCAB reduces only mild to moderate AKI but not severe AKI requiring dialysis.…”

Neurological Complications of On-Pump versus Off-Pump Coronary Artery Bypass Graft Surgery

“…While avoidance of cannulation and cross-clamping of the aorta by itself reduces aortic manipulation and the risk of embolic debris the placement of vein grafts to the ascending Licensed Under Creative Commons Attribution CC BY aorta increases the risk. In a meta-analysis of 11,398 patients from eight studies, Misfield and colleagues reported that the relative risk of neurological injury was 0.46 (95% confidence intervals 0.29-0.72; p = 0.0008) when there was complete avoidance of any aortic manipulation (16) Like in several other studies, in our study, off pump CABG, is shown to be safe, effective and with less neurological complications. The reason for that is avoidance of cardiopulmonary bypass, cross clamp of the aorta and use of sequential anastomosis, also the experience of our surgeons on the off pump technique.…”

On- versus off-pump coronary artery bypass-Another nail in the coffin?

“…Most importantly, the data derived from this meta‐analysis could not determine what factors were responsible for the increased mortality observed in the OPCAB group. Previous meta‐analyses have found that OPCAB was associated with a significant increase in graft occlusion from both saphenous vein and arterial grafts, in addition to a decreased number of total grafts/patient . However, in the current meta‐analysis, although the number of grafts/patient was significantly decreased in the OPCAB patients, there was no difference in the need for repeat revascularization or the use of all arterial grafting between the groups.…”

“…Previous meta-analyses have found that OPCAB was associated with a significant increase in graft occlusion from both saphenous vein and arterial grafts, in addition to a decreased number of total grafts/patient. 7,8 However, in the current meta-analysis, although the number of grafts/patient was significantly decreased in the OPCAB patients, there was no difference in the need for repeat revascularization or the use of all arterial grafting between the groups. Furthermore, while the number of grafts was decreased in the OPCAB group, we are not told whether this was due to incomplete revascularization, or merely that there was a decrease in the number of distal targets that actually required grafting.…”

Comparison of renal outcomes in off‐pump versus on‐pump coronary artery bypass grafting: A systematic review and meta‐analysis of randomized controlled trials

“…Despite the reduction in the incidence of AKI, OPCAB did not decrease the requirement of renal replacement therapy after cardiac surgery. This finding of our updated meta‐analysis is consistent with the results in previous published meta‐analyses on this topic . This result reflects that OPCAB reduces only mild to moderate AKI but not severe AKI requiring dialysis.…”

Neurological Complications of On-Pump versus Off-Pump Coronary Artery Bypass Graft Surgery

“…While avoidance of cannulation and cross-clamping of the aorta by itself reduces aortic manipulation and the risk of embolic debris the placement of vein grafts to the ascending Licensed Under Creative Commons Attribution CC BY aorta increases the risk. In a meta-analysis of 11,398 patients from eight studies, Misfield and colleagues reported that the relative risk of neurological injury was 0.46 (95% confidence intervals 0.29-0.72; p = 0.0008) when there was complete avoidance of any aortic manipulation (16) Like in several other studies, in our study, off pump CABG, is shown to be safe, effective and with less neurological complications. The reason for that is avoidance of cardiopulmonary bypass, cross clamp of the aorta and use of sequential anastomosis, also the experience of our surgeons on the off pump technique.…”

On- versus off-pump coronary artery bypass-Another nail in the coffin?

“…Most importantly, the data derived from this meta‐analysis could not determine what factors were responsible for the increased mortality observed in the OPCAB group. Previous meta‐analyses have found that OPCAB was associated with a significant increase in graft occlusion from both saphenous vein and arterial grafts, in addition to a decreased number of total grafts/patient . However, in the current meta‐analysis, although the number of grafts/patient was significantly decreased in the OPCAB patients, there was no difference in the need for repeat revascularization or the use of all arterial grafting between the groups.…”

“…Previous meta-analyses have found that OPCAB was associated with a significant increase in graft occlusion from both saphenous vein and arterial grafts, in addition to a decreased number of total grafts/patient. 7,8 However, in the current meta-analysis, although the number of grafts/patient was significantly decreased in the OPCAB patients, there was no difference in the need for repeat revascularization or the use of all arterial grafting between the groups. Furthermore, while the number of grafts was decreased in the OPCAB group, we are not told whether this was due to incomplete revascularization, or merely that there was a decrease in the number of distal targets that actually required grafting.…”

Comparison of renal outcomes in off‐pump versus on‐pump coronary artery bypass grafting: A systematic review and meta‐analysis of randomized controlled trials

“…Despite the reduction in the incidence of AKI, OPCAB did not decrease the requirement of renal replacement therapy after cardiac surgery. This finding of our updated meta‐analysis is consistent with the results in previous published meta‐analyses on this topic . This result reflects that OPCAB reduces only mild to moderate AKI but not severe AKI requiring dialysis.…”

Neurological Complications of On-Pump versus Off-Pump Coronary Artery Bypass Graft Surgery

“…While avoidance of cannulation and cross-clamping of the aorta by itself reduces aortic manipulation and the risk of embolic debris the placement of vein grafts to the ascending Licensed Under Creative Commons Attribution CC BY aorta increases the risk. In a meta-analysis of 11,398 patients from eight studies, Misfield and colleagues reported that the relative risk of neurological injury was 0.46 (95% confidence intervals 0.29-0.72; p = 0.0008) when there was complete avoidance of any aortic manipulation (16) Like in several other studies, in our study, off pump CABG, is shown to be safe, effective and with less neurological complications. The reason for that is avoidance of cardiopulmonary bypass, cross clamp of the aorta and use of sequential anastomosis, also the experience of our surgeons on the off pump technique.…”

On- versus off-pump coronary artery bypass-Another nail in the coffin?

“…Most importantly, the data derived from this meta‐analysis could not determine what factors were responsible for the increased mortality observed in the OPCAB group. Previous meta‐analyses have found that OPCAB was associated with a significant increase in graft occlusion from both saphenous vein and arterial grafts, in addition to a decreased number of total grafts/patient . However, in the current meta‐analysis, although the number of grafts/patient was significantly decreased in the OPCAB patients, there was no difference in the need for repeat revascularization or the use of all arterial grafting between the groups.…”

“…Previous meta-analyses have found that OPCAB was associated with a significant increase in graft occlusion from both saphenous vein and arterial grafts, in addition to a decreased number of total grafts/patient. 7,8 However, in the current meta-analysis, although the number of grafts/patient was significantly decreased in the OPCAB patients, there was no difference in the need for repeat revascularization or the use of all arterial grafting between the groups. Furthermore, while the number of grafts was decreased in the OPCAB group, we are not told whether this was due to incomplete revascularization, or merely that there was a decrease in the number of distal targets that actually required grafting.…”