Safety and efficacy of miniaturized extracorporeal circulation when compared with off-pump and conventional coronary artery bypass grafting: evidence synthesis from a comprehensive Bayesian-framework network meta-analysis of 134 randomized controlled trials involving 22 778 patients

Abstract

MECC and OPCAB both improve perioperative outcomes following coronary bypass surgery when compared with conventional CABG performed with extracorporeal circulation. MECC may represent an attractive compromise between OPCAB and CECC.

Conventional or minimized cardiopulmonary bypass support during coronary artery bypass grafting? – An analysis by means of perfusion and body mass index

“…The presumed advantages of "off-pump" surgery are lower stroke rates and less systemic inflammation at the expense of incomplete The main finding of this analysis was a clear advantage of minimized bypass and "off-pump" use with regard to mortality and stroke rates, atrial fibrillation, and renal dysfunction. Of note is that minimized bypass systems and the "off-pump" strategy have shown comparable results (5). Therefore, the use of minimized bypass systems is a promising alternative to reduce adverse effects of cardiopulmonary bypass support.…”

“…However, because artificial extracorporeal circuits are associated with non‐physiological blood air contact, hemodilution, and substantial inflammatory response , the concept of minimized cardiopulmonary bypass support was devised in 2004 . Since then, various benefits of minimized cardiopulmonary bypass systems have been reported, such as fewer transfusion requirements, a lower stroke rate, a lower rate of postoperative atrial fibrillation, and renal protection . Yet, outcome data (myocardial infarction and mortality) and inflammatory response are still contradictorily discussed .…”

“…PROVAZNIK et al support was devised in 2004 (4). Since then, various benefits of minimized cardiopulmonary bypass systems have been reported, such as fewer transfusion requirements, a lower stroke rate, a lower rate of postoperative atrial fibrillation, and renal protection (5). Yet, outcome data (myocardial infarction and mortality) and inflammatory response are still contradictorily discussed (5,6).…”

On-Pump vs Off-Pump coronary artery bypass surgery in atrial fibrillation. Analysis from the polish national registry of cardiac surgery procedures (KROK)

“…This percentage is known to further increase with older age, and depressed left ventricular function [5] that is in patients more and more frequently referred for CABG surgery. There exists robust evidence to support performing CABG in higher risk patients [6,7] without the use of cardiopulmonary bypass (CPB) (Off-Pump CABG) to avoid deleterious effects of extracorporeal circulation (ECC) and its consequences: transfusions, renal failure, bleeding and cerebrovascular events [8]. On the other hand, On-Pump CABG and arrested heart offer bloodless operative field and allow complete revascularization in most, often very complex cases [9][10][11].…”

Haemostasis and minimally invasive extracorporeal circulation

“…По данным метаанализа 2016 г., сравнению MiECC (1 522 пациентов) и стандартного ИК (1 534 пациентов) посвящено 32 рандомизированных исследования [6].…”