Myocardial preservation during coronary surgery with and without cardiopulmonary bypass

Penttilä, Hannu J; Lepojärvi, Martti; Kiviluoma, Kai; Kaukoranta, Päivi; Hassinen, Ilmo E.; Peuhkurinen, Keijo

doi:10.1016/s0003-4975(00)02002-6

Cited by 79 publications

(43 citation statements)

References 19 publications

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“…In fact, Atkins, et al first suggested that OPCAB preserved cardiac function in 1984 [14]. In different prospective randomized studies, Ascione [15], Penttilä [16], Van Dijk [17], Czerny [18], Bennetts [19], and Masuda [20], and their collaborators reported minimal change in the biochemical markers of myocardial injury (troponin T and/or creatinine kinase-MB isoenzyme), and in some cases, better myocardial function after OPCAB compared to on-pump CABG. Changes in myocardial metabolism indicative of oxidative stress due to local ischemia when the target coronary artery is occluded to enable visualizetion for distal anastomoses have been reported in OP-CAB [21].…”

Section: Myocardial Preservationmentioning

confidence: 99%

“…Changes in myocardial metabolism indicative of oxidative stress due to local ischemia when the target coronary artery is occluded to enable visualizetion for distal anastomoses have been reported in OP-CAB [21]. Compared to on-pump CABG, OPCAB is associated with better myocardial energy preservation, less oxidative stress and minimal myocardial damage [16]. However, emerging evidence suggests that intraoperative myocardial protection in OPCAB can provide an added advantage [22,23].…”

Section: Myocardial Preservationmentioning

confidence: 99%

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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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Section: Myocardial Preservationmentioning

confidence: 99%

Section: Myocardial Preservationmentioning

confidence: 99%

Re-engineering in OPCAB—A Vettath’s perspective

Vettath¹,

Ismail²,

Kannan³

2013

WJCD

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“…By avoiding the atrial myocyte alterations that result from aortic crossclamping and avoiding the systemic inflammatory response to CPB, OPCAB should decrease the incidence of postoperative AF [28]. There is a general consensus from randomized trials [18,53,54] and prospective nonrandomized cohort studies [55,56] that CABG performed using CPB and cardioplegic arrest is associated with a significantly greater degree of myocardial injury than OPCAB. Puskas et al [11] founds no difference in the incidence of atrial fibrillation between groups, despite the absence of atrial sutures, cannulation, and CPB in the offpump group.…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Is it time to adopt beating-heart coronary artery bypass grafting? A review of literature

Hijazi¹

2010

Rev Bras Cir Cardiovasc

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“…Surgical revascularization by coronary artery bypass grafting (CABG) using Cardiopulmonary bypass (CPB) is widely used, safe and effective procedure with a low mortality rate (1). Off-pump coronary artery bypass (OPCAB) involves bypass grafting on a beating heart without the employment of CPB 2 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of myocardial protection in off-pump vs on-pump coronary bypass surgery by troponin I estimation

Badruzzaman

Hossain

Adhikary

et al. 2011

Bangladesh Med Res Counc Bull

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Background: This prospective non-randomized clinical study was done to compare Off-pump and Onpump myocardial revascularization by Troponin I release in patients undergoing first elective coronary artery bypass graft used to evaluate myocardial injury. Methods: One hundred an twenty patients were non-randomly assigned to a Off-pump or On-pump myocardial revascularization group. Cardiac Troponin I (CTnI) were measured in serial venous blood samples drawn preoperatively in both groups. In On-pump group after aortic unclamping at 12 and 24 hours and in Off-pump group after the last distal anastomosis at 12 and 24 hours. Results: The total amount of CTnI release were significantly higher in On-pump group than in Off-pump group. In On-pump group it was 2.1±1.9 (mean±SD) ng/ml vs in Off-pump group it was 1.0±1.7 (mean±SD) ng/ml at 12 hours and in On-pump group it was 1.6±1.6 (mean±SD) ng/ml vs in Off-pump group it was .9±1.6 (mean±SD) ng/ml at 24 hours (P<0.0001 for the pattern). Conclusion: The lower release of CTnI in the Off-pump myocardial revascularization group indicates that the arrested heart coronary revascularization group causes more damage to the heart due to cardiopulmonary bypass than Off-pump myocardial revascularization group.

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Myocardial preservation during coronary surgery with and without cardiopulmonary bypass

Cited by 79 publications

References 19 publications

Re-engineering in OPCAB—A Vettath’s perspective

Re-engineering in OPCAB—A Vettath’s perspective

Is it time to adopt beating-heart coronary artery bypass grafting? A review of literature

Evaluation of myocardial protection in off-pump vs on-pump coronary bypass surgery by troponin I estimation

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