Comparison of minimized circulation with off-pump coronary artery bypass (OPCAB) grafting and conventional surgery

WOS: 000311569100015The development of effective devices for target vessel exposure and stabilization and the subsequent widespread diffusion of off-pump coronary artery bypass (OPCAB) as an alternative technique to conventional on-pump revascularization is discussed. Application of the OPCAB concept for patients with specific cardiac and extracardiac risks and the benefits of avoiding cardiopulmonary bypass (CPB) are explored. The consequences of incomplete revascularization and the high mortality for conversion to CPB are examined. OPCAB with assisted mini-CPB is confirmed as an emerging option which provides an excellent surgical exposure with a stable cardiac output for performing an ideal anastomosis and decreasing the inflammatory deleterious effects of the conventional CPB

Comparison of minimized circulation with off-pump coronary artery bypass (OPCAB) grafting and conventional surgery (2)

The development of effective devices for target vessel exposure and stabilization and the subsequent widespread diffusion of off-pump coronary artery bypass (OPCAB) as an alternative technique to conventional on-pump revascularization is discussed. Application of the OPCAB concept for patients with specific cardiac and extracardiac risks and the benefits of avoiding cardiopulmonary bypass (CPB) are explored. The consequences of incomplete revascularization and the high mortality for conversion to CPB are examined. OPCAB with assisted mini-CPB is confirmed as an emerging option which provides an excellent surgical exposure with a stable cardiac output for performing an ideal anastomosis and decreasing the inflammatory deleterious effects of the conventional CPB. © 2012 Woodhead Publishing Limited. All rights reserved

Impact of the intensity of microemboli on neurocognitive outcome following cardiopulmonary bypass

WOS: 000317988500013PubMed: 23381348Background: This study aimed to determine whether there was any association between the intensity of intraoperative gaseous microembolic signals (GME), neuropsychological testing and clinical outcome in high-risk patients undergoing coronary artery surgery (CABG). Methods: Over a 6-month period, GME activity was monitored in 102 Euroscore 6+ patients during cardiopulmonary bypass (CPB) with a conventional 32-micron arterial filter by non-invasive, real-time ultrasonic device. Cognitive tests; line bisection, the Stroop test, finger tapping, and the Rey Auditory Verbal Learning Test were performed at baseline, postoperative one week and postoperative one month. Results: The distribution of GME activity showed that there were three groups of patients: >500 total emboli (n = 38); 250 to 500 emboli (n = 30) and 500 emboli patients versus control (<250 emboli) in postoperative week one, but resolved in one month. Conclusions: Correlation between intraoperative GME intensity and neurocognitive tests suggests that the level of GME might have a role in determining the psychological outcome after CABG with CPB.University of Kirikkale Research FundKirikkale UniversityThis study is supported by University of Kirikkale Research Fund