Perioperative Patency of Coronary Artery Bypass Grafting is Not Influenced by Off-Pump Technique

Olivito, Silvio; Mastroroberto, Pasquale; Virgilio, Antonio Di; Esposito, Antonio; Perrotti, Andréa; Renzulli, Attilio

doi:10.1016/j.athoracsur.2005.05.075

Cited by 14 publications

(9 citation statements)

References 21 publications

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“…Overall 1-and 5-year patency following OPCAB have been very good, at 91.9% and 88.3%, respectively (63). Moreover, OPCAB grafts demonstrate equivalent flow, pulsatility and flow reserve when compared to CABG further demonstrating equivalent, highly patent anastomoses (64). Pharmacological stress 201 thallium single-photon emission computed tomography confirm similar perfusion characteristics post-bypass for the OPCAB and CABG groups (65).…”

Section: Coronary Artery Bypass Grafting On Cardiopulmonary Bypass Ormentioning

confidence: 49%

Untitled

2009

Robotics Computer Surgery

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Coronary artery disease is a global health concern, with increasing morbidity and mortality. Surgical coronary artery bypass grafting has been performed on cardiopulmonary bypass for nearly four decades, with excellent long-term durability. Beating-heart coronary surgery has been increasing in frequency in an attempt to decrease cardiopulmonary bypass-related morbidity. Furthermore, with increasing expertise and technology, minimally invasive and robotic techniques have been developed to enhance postoperative recovery, patient satisfaction and cosmesis. Several clinical trials have demonstrated decreased morbidity and more rapid recovery following off-pump, minimally invasive and robotic procedures when compared to on-pump coronary artery bypass grafts (CABGs). An equivalent extent of revascularization and medium-term anastomotic patency has been demonstrated among all approaches. Furthermore, for a large number of patients who do not have anatomy amenable to traditional coronary revascularization, adjunctive molecular therapies may provide alternative myocardial micro-revascularization.

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Section: Coronary Artery Bypass Grafting On Cardiopulmonary Bypass Ormentioning

confidence: 49%

Untitled

2009

Robotics Computer Surgery

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“…Although prospective randomized trials carried in the hands of surgeon with high level of expertise have shown that early patency and adequacy of the revascularization could be equivalent between on and off-pump revascularization [83,91], meta-analyses have reported a decrease in the number of grafts with OPCAB surgery and a lower patency rate especially with vein graft [92,93]. However, recent studies tend to demonstrate similar transit-time flowmetric results, as well as comparable graft flow reserve with both techniques [94]. A publication assessing long-term patency results obtained from early randomized trials has also shown similar results for both techniques [95 ].…”

Section: Off-pump Coronary Artery Bypass Surgerymentioning

confidence: 89%

Off-pump coronary artery revascularization in octogenarians: is it better?

Cartier

2009

Current Opinion in Cardiology

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Although OPCAB surgery has gained popularity over the past 15 years, its benefit regarding operative mortality and major complications has not been clearly defined in the general population. There is a body of literature supporting its benefit in the elderly population. OPCAB surgery has the potential of decreasing operative mortality and major postoperative complications such as stroke, delirium, atrial fibrillation, and decline in neurocognitive functions in these patients. Off-pump surgery is technically more demanding and has been blamed for providing less complete revascularization and lower graft patency rate, especially in less experienced hands. However, with the upcoming demographic explosion of senior citizens in western societies, OPCAB surgery has definitely to be a part of the armamentarium of modern cardiac surgeons.

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“…Moreover, good TTF results can be helpful in the decision-making process whenever complications, such as minor EKG changes, hypotension or arrhythmias occur during the sternal closure, if repeated TTF confirms unchanged findings [9,13].…”

Section: Discussionmentioning

confidence: 99%

“…According to an Institutional policy, inotropes were started immediately after aortic cross-clamp removal with enoximone at a dosage of 5 μg/kg/min [13]. Inotropic support was defined as low dose when enoximone was administered at a dosage lower than or equal to 5 μg/kg/min, medium dose was defined when enoximone was employed at a dosage between 6 and 10 μg/kg/min, or dobutamine was added at a dosage between 5 and 10 μg/ kg/min, and high dose when enoximone or dobutamine infusion was N10 μg/kg/min or epinephrine at any dose was added.…”

Section: Post-operative Care Biochemical Analysis and Echocardiographymentioning

confidence: 99%