Subsystem organ function during coronary surgery

Abstract

Conventional coronary artery bypass grafting (CABG) carries a mortality rate of 1% to 2% in elective patients. However, despite advances in perfusion, anaesthetic, and surgical techniques cardiopulmonary bypass (CPB) is still associated with subsystem dysfunction. Off-pump coronary artery bypass grafting (OPCAB) has recently gained popularity as a potentially more physiological method to maintain the functional integrity of major organ systems. The review of observational reports, case-matched studies and prospective randomized trials seems to suggest that OPCAB surgery reduces postoperative subsystem organ dysfunction when compared with conventional coronary revascularisation.

Inflammatory response and cardioprotection during open‐heart surgery: the importance of anaesthetics

“…It is now widely accepted that beating heart surgery performed without the aid of CPB significantly attenuates cytokine and stress response ( Ganapathy et al , 2001 ; Raja, 2004 ; Yamaguchi et al , 2005 ; Lehmann et al , 2006 ). The reduced inflammatory response has been associated with improvement in organ function ( Ascione et al , 2000 , 2001 , 2002a , 2002b ; Caputo et al , 2002b ) and postoperative bleeding ( Raja and Dreyfus, 2006 ). However, as the inflammatory response is only reduced and not prevented, it is likely to continue to influence cardiac function and clinical outcome ( Quaniers et al , 2006 ).…”