When compared with conventional coronary artery bypass grafting with cardiopulmonary bypass, off-pump coronary artery bypass grafting achieved similar completeness of revascularization, similar in-hospital and 30-day outcomes, shorter length of stay, reduced transfusion requirement, and less myocardial injury.
OTIVATED BY MORBIDITY attributable to cardiopulmonary bypass, 1-3 US surgeons performed approximately 21% of coronary artery bypass operations off-pump in 2002. 4 Nonetheless, concern remains about the technical difficulty of off-pump coronary artery bypass (OPCAB), including the possibility of imprecise anastomoses and incomplete revascularization compromising patient outcomes. 5-9 Two prospective, randomized studies 10,11 and all but a few 12 retrospective comparisons have reported significantly fewer grafts in OPCAB. Retrospective studies among selected patients showing sig
We have shown that the heparin anticoagulation regimen in OPCAB patients does not lead to an immediate hypercoagulable state. Total doses of heparin and protamine were lower in the OPCAB group compared with the CABG group, and there was a residual heparin effect on TEG and PTT in the early postoperative period in the OPCAB group.
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