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Multivessel corornary bypass grafting without cardiopulmonary support

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Abstract

Coronary artery bypass grafting without the aid of cardiopulmonary bypass (CPB) continues to gain popularity as an alternative to standard techniques of revascularization. CPB with cardioplegic arrest is associated with complications that may negate an otherwise technically flawless procedure. Experience has identified aspects crucial to the success of off-pump bypass grafting, such as patient selection, anesthetic and operative technique, and grafting sequence. We review recent technical advances and reported results for multivessel bypass grafting without CPB.

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References and Recommended Reading

  1. Gibbon JH Jr: Application of a mechanical heart and lung apparatus in cardiac surgery. Minn Med 1954, 37:171.

    PubMed  Google Scholar 

  2. The Veterans Administration Coronary Artery Bypass Surgery Cooperative Study Group: Eleven year survival in the Veterans Administration Randomized Trial of Coronary Bypass Surgery for stable angina. N Engl J Med 1984, 311:133–139.

    Google Scholar 

  3. European Coronary Surgery Study Group: Long-term results of prospective randomized study of coronary artery bypass surgery in stable angina pectoris. Lancet 1982, 2:1173–1180.

    Google Scholar 

  4. CASS Principal Investigators and their Associates: Coronary artery surgery study (CASS): A randomized trial of coronary artery bypass surgery. Survival data. Circulation 1983, 68:939–950.

    Google Scholar 

  5. Pacifico AD, Digerness S, Kirklin JW: Acute alterations of body composition after open intracardiac operations. Circulation 1970, 41:331–341.

    PubMed  CAS  Google Scholar 

  6. Woodman RC, Harker LA: Bleeding complications associated with cardiopulmonary bypass. Bloo 1990, 76:1680–1697.

    CAS  Google Scholar 

  7. Blackstone EH, Kirklin JW, Stewart RW, et al.: The damaging effects of cardiopulmonary bypass. In In Prostaglandins in Clinical Medicine: Cardiovascular and Thrombotic Disorders. Edited by Wu KK, Roxy EC. Chicago: Yearbook Medical Publishers; 1982:355–369.

    Google Scholar 

  8. Ratliff NB, Young WG, Hackel D, et al.: Pulmonary injury secondary to extracorporeal circulation: An ultrastructural study. J Thorac Cardiovasc Surg 1973, 65:425–432.

    PubMed  CAS  Google Scholar 

  9. Westaby S: Complement and the damaging effects of cardiopulmonary bypass. Thorax 1983, 38:321–325.

    Article  PubMed  CAS  Google Scholar 

  10. Shaw PJ, Bates D, Aartidge NEF, et al.: Neurologic and neuropsychological morbidity following major surgery: Comparison of coronary artery bypass and peripheral vascular surgery. Stroke 1987, 18:700–707.

    PubMed  CAS  Google Scholar 

  11. Kurusz M, Butler BD: Embolic events and cardiopulmonary bypass. In In Cardiopulmonary Bypass. Edited by Gravlee GP, Davis RF, Utley JR. Baltimore: Williams & Wilkins; 1993:267–290.

    Google Scholar 

  12. BhaskerRao B, Vanhimbergan D, Edmunds HL, et al.: Evidence for improved cerebral function after minimally invasive bypass surgery J Card Surg 1998, 13:27–31.

    Article  PubMed  CAS  Google Scholar 

  13. Kolesov VI: Mammary artery-coronary artery anastomosis as method of treatment for angina pectoris. J Thorac Cardiovasc Surg 1967, 54:535–544.

    Google Scholar 

  14. Spooner TH, Dyrud PE, Monson BK, et al.: Coronary artery bypass on the beating heart with the Octopus: A North American Experience. Ann Thorac Surg 1998, 66:1032–1035.

    Article  PubMed  CAS  Google Scholar 

  15. Puskas JD, Wright CE, Ronson RS, et al.: Off-pump multivessel coronary bypass via sternotomy is safe and effective Ann Thorac Surg 1998, 66:1068–1072. A prospective review of off-pump bypass showing equivalent patenc to grafting with CPB.

    Article  PubMed  CAS  Google Scholar 

  16. Jansen EW, Borst C, Lahpor JR, et al.: Coronary artery bypass grafting without cardiopulmonary bypass using the octopus method: Results in the first one hundred patients. J Thorac Cardiovasc Surg 1998, 116 60–67

    Article  PubMed  CAS  Google Scholar 

  17. Tasdemir O, Vural KM, Karagoz H, et al.: Coronary artery bypass grafting on the beating heart without the use of extracorporal circulation: Review of 2052 cases. J Thorac Cardiovasc Surg 1998, 116 68–73. The largest experience published on off-pump grafting from a single center.

    Article  PubMed  CAS  Google Scholar 

  18. Baumgartner FJ, Gheissari A, Capouya ER, et al.: Technical aspects of total revascularization in off-pump coronary bypass via sternotomy approach. Ann Thorac Surg 1999, 67:1653–1658. Overview of techniques used for off-pump bypass grafting using the CTS stabilizer.

    Article  PubMed  CAS  Google Scholar 

  19. Buffolo E, Andrade JC, Branco JN, et al.: Coronary artery bypass grafting without cardiopulmonary bypass. Ann Thorac Surg 1996, 61:63–66.

    Article  PubMed  CAS  Google Scholar 

  20. Bredee JJ, Jansen EW: Coronary artery bypass grafting without cardiopulmonary bypass. Curr Opin Cardiol 1998, 13:476–482. A comprehensive overview of off-pump grafting with emphasis on patient selection and operative technique.

    Article  PubMed  CAS  Google Scholar 

  21. Pfister AJ, Zaki S, Garcia JM, et al.: Coronary artery bypass without cardiopulmonary bypass. Ann Thorac Surg 1992, 54:1085–1092

    Article  PubMed  CAS  Google Scholar 

  22. Dewey TM, Edgerton J, Mathison M: Off pump bypass grafting is safe with left main coronary disease. Ann Thorac Surg. 1999, in press.

  23. Grundeman PF, Borst C, Verlaan CW, et al.: Exposure of circumflex branches in the tilted, beating porcine heart: Echocardiographic evidenceof right ventricular deformation and the effect of right or left heart bypass. J Thorac Cardiovasc Surg 1999, 118:316–323. Animal study identifying the anatomic alterations incurred with positioning the heart, and their hemodynamic consequences.

    Article  PubMed  CAS  Google Scholar 

  24. Calafiore AM, Teodori G, Giammarco GD: Multiple arterial conduits without cardiopulmonary bypass: Early angiographic results. Ann Thorac Surg 1999, 67 450–456. Overview of results with the use of multiple arterial grafts in off-pump patients.

    Article  PubMed  CAS  Google Scholar 

  25. Persson L, Haardemark HG, Gustafsson J, et al.: S-100 protein and neuron-specific enolase in cerebrospinal fluid and serum: Markers of cell damage in human nervous system. Stroke 1987, 18 911–918.

    PubMed  CAS  Google Scholar 

  26. Blomquist S, Johnsson P, Luhrs C, et al.: The appearance of S-100 protein in serum during and immediately after cardiopulmonary bypass surgery: A possible marker for cerebral injury. J Cardiothorac Vasc Anesth 1997, 11:699 703.

    Article  PubMed  Google Scholar 

  27. Svenmarker S, Sandstrom E, Karlsson T, et al.: Clinical effects of the heparin coated surface in cardiopulmonary bypass. Eur J Cardiothorac Surg 1997, 11:957–964.

    PubMed  CAS  Google Scholar 

  28. Taggert DP, Mazel JW, Bhattacharya K, et al.: Comparison of serum S100B levels during CABG and intracardiac operations. Ann Thorac Surg 1997, 63:492–496.

    Article  Google Scholar 

  29. Westaby S, Johnsson P, Parry AJ, et al.: Serum S100B protein A potential marker for cerebral events during cardiopulmonary bypass. Ann Thorac Surg 1996, 61:88 92.

    Article  PubMed  Google Scholar 

  30. Anderson RE, Hansson LO, Vaage J: Release of S100B during coronary artery bypass grafting is reduced by off-pump surgery. Ann Thorac Surg 1999, 67:1721–1725.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Medical City Dallas, 7777 Forest Lane, Suite 323, 75230, Dallas, TX, USA

    Todd M. Dewey MD & Michael J. Mack MD

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  1. Todd M. Dewey MD
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  2. Michael J. Mack MD
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Dewey, T.M., Mack, M.J. Multivessel corornary bypass grafting without cardiopulmonary support. Curr Cardiol Rep 1, 313–317 (1999). https://doi.org/10.1007/s11886-999-0056-2

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  • DOI: https://doi.org/10.1007/s11886-999-0056-2

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