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Review Article

Deleterious effects of cardiopulmonary bypass in coronary artery surgery and scientific interpretation of off‐pump's logic

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Pages 196-209 | Published online: 10 Jul 2009

References

  • Elahi M. M., Khan J. S. Living with off‐pump coronary artery surgery: evolution, development, and clinical potential for coronary heart disease patients. Heart Surg Forum 2006; 9: 630–7
  • Sabik J. F., Gillinov A. M., Blackstone E. H., et al. Does off‐pump coronary surgery reduce morbidity and mortality?. J Thorac Cardiovasc Surg 2002; 124: 698–707
  • Cleveland J. C., Shroyer A. L., Chen A. Y., Peterson E., Grover F. L. Off‐pump coronary artery bypass grafting decrease risk‐adjusted mortality and morbidity. Ann Thorac Surg 2001; 72: 1282–9
  • Ascione R., Angelini G. D. Off‐pump coronary artery bypass surgery: the implications of the evidence. J Thorac Cardiovasc Surg 2003; 125: 779–81
  • Abu‐Omar Y., Taggart D. P. Off‐pump coronary artery bypass grafting. Lancet 2002; 360: 327–30
  • Pepper J. Controversies in off‐pump coronary artery surgery. Clin Med Res 2005; 3: 27–33
  • Gu Y. J., Mariani M. A., van Oeveren W., Grandjean J. G., Boonstra P. W. Reduction of the inflammatory response in patients undergoing minimally invasive coronary artery bypass grafting. Ann Thorac Surg 1998; 65: 420–4
  • Struber M., Cremer J. T., Gohrbandt B., et al. Human cytokine responses to coronary artery bypass grafting with and without cardiopulmonary bypass. Ann Thorac Surg 1999; 68: 1330–5
  • Ascione R., Lloyd C. T., Underwood M. J., Lotto A. A., Pitsis A. A., Angelini G. D. Inflammatory response after coronary revascularization with or without cardiopulmonary bypass. Ann Thorac Surg 2000; 69: 1198–204
  • Matata B. M., Sosnowski A. W., Galinanes M. Off‐pump bypass graft operation significantly reduces oxidative stress and inflammation. Ann Thorac Surg 2000; 69: 785–91
  • Diegeler A., Doll N., Rauch T., Haberer D. Humoral immune response during coronary artery bypass grafting: a comparison of limited approach, ‘off‐pump’ technique, and conventional cardiopulmonary bypass. Circulation 2000; 102: 95–100
  • Schulze C., Conrad N., Schutz A., et al. Reduced expression of systemic proinflammatory cytokines after off‐pump versus conventional coronary artery bypass grafting. Thorac Cardiovasc Surg 2000; 48: 364–9
  • Chello M., Mastroroberto P., Quirino A., et al. Inhibition of neutrophil apoptosis after coronary bypass operation with cardiopulmonary bypass. Ann Thorac Surg 2002; 73: 123–30
  • Massoudy P., Zahler S., Tassani P., et al. Reduction of pro‐inflammatory cytokine levels and cellular adhesion in CABG procedures with separated pulmonary and systemic extracorporeal circulation without an oxygenator. Eur J Cardiothorac Surg 2000; 17: 729–36
  • Czerny M., Baumer H., Kilo J., et al. Inflammatory response and myocardial injury following coronary artery bypass grafting with or without cardiopulmonary bypass. Eur J Cardiothorac Surg 2000; 17: 737–42
  • Wan S., Izzat M. B., Lee T. W., Wan I. Y., Tang N. L., Yim A. P. Avoiding cardiopulmonary bypass in multivessel CABG reduces cytokine response and myocardial injury. Ann Thorac Surg 1999; 68: 52–6
  • Wei M., Kuukasjarvi P., Laurikka J., et al. Cytokine responses and myocardial injury in coronary bypass grafting. Scand J Clin Lab Invest 2001; 61: 161–6
  • Oz M. C., Liao H., Naka Y., et al. Ischemia‐induced interleukin‐8 release after human heart transplantation. A potential role for endothelial cells. Circulation 1995; 92: 428–32
  • Isomaki P., Punnonen J. Pro‐ and anti‐inflammatory cytokines in rheumatoid arthritis. Ann Med 1997; 29: 499–507
  • Casati V., Gerli C., Franco A., et al. Activation of coagulation and fibrinolysis during coronary surgery: on‐pump versus off‐pump techniques. Anesthesiology 2001; 95: 1103–9
  • Gerritsen W. B. M., van Boven W. J. P., Driessen A. H. G., Haas F. J. L. M., Aarts L. P. H. J. Off‐pump versus on‐pump coronary artery bypass grafting: oxidative stress and renal function. Eur J Cardiothorac Surg 2001; 20: 923–92
  • van Dijk D., Nierich A. P., Jansen E., et al. Early outcome after off‐pump versus on‐pump coronary bypass surgery‐ results from a randomized study. Circulation 2001; 104: 1761–6
  • Elahi M. M., Elahi M., Matata B. M. Covalent modification of C3 and C4 protein chains by ROS augment Mannan Binding‐Lectin Pathway activation in an extracorporeal blood recirculation model. Mol Immunol 2006; 43: 153
  • Matata B. M., Sosnowski A. W., Galinanes M. Off‐pump coronary bypass graft surgery: Evidence of a significant reduction in protein nitration and oxidative stress. Circulation 1999; 100: 3510
  • Matata B. M., Elahi M. M. Peroxynitrite: an intriguing double‐agent in biology and cardiovascular disease. Recent Research Developments in Biophysics Vol 3 Part I Transworld Research Communications, S. G Pandalai, 2004; 93–112, Gayathri Publishers
  • Elahi M. M., Matata B. M. Blood‐dependent redox activity during extracorporeal circulation in health and disease. The Cardiology 2005; 1: 156–7
  • Elahi M. M., Matata B. M., Galinanes M. Nitric Oxide modulates the inflammatory response to extracorporeal circulation of blood through activation of NF Kappa‐B. Circulation 2004; 110: 358
  • Matata B. M., Galinanes M. Cardiopulmonary bypass exacerbates oxidative stress but does not increase proinflammatory cytokine release in patients with diabetes compared with patients without diabetes: Regulatory effects of exogenous nitric oxide. J Thorac Cardiovasc Surg 2000; 120: 1–11
  • Favaloro R. G., Effler D. B., Groves L. K., Sheldon W. C., Sones F. M. Direct myocardial revascularization by saphenous vein graft. Present operative technique and indications. Ann Thorac Surg 1970; 10: 97–111
  • Trapp W. G., Bisarya R. Placement of coronary artery bypass graft without pump oxygenator. Ann Thorac Surg 1975; 19: 1–9
  • Benetti F. J., Naselli C., Wood M., Geffner L. Direct myocardial revascularization without extracorporeal circulation. Experience in 700 patients. Chest 1991; 100: 312–6
  • Buffolo E., de Andrade J. C. S., Rodrigues Branco J. N. R., Teles C. A., Aguiar L. F., Gomes W. J. Coronary artery bypass grafting without cardiopulmonary bypass. Ann Thorac Surg 1996; 61: 63–6
  • Buckberg G. D., Allen B. S. Myocardilal protection management during adult cardiac operations. Glenn's thoracic and cardiovascular surgery, A. E Baue, A. S Geha, G. L Hammond, H Laks, K. S Naunheim. Apple & Lange, Stamford 1996; 1653–87
  • Mehlhorn U., Allen S. J., Adams D. L., et al. Normothermic continuous antegrade blood cardioplegia does not prevent myocardial edema and cardiac dysfunction. Circulation 1995; 92: 1940–6
  • Bennetts J. S., Baker R., Ross I. K., Knight J. L. Assessment of myocardial injury by troponin T in off‐pump coronary artery grafting and conventional coronary artery graft surgery. ANZ J Surg 2002; 72: 105–9
  • Masuda M., Morita S., Tomita H., et al. Off‐pump attenuates myocardial enzyme leakage but not postoperative brain natriuretic peptide secretion. Ann Thorac Cardiovasc Surg 2002; 8: 139–44
  • Muraki S., Morris C. D., Budde J. M., et al. Experimental off‐pump coronary artery revascularization with adenosine‐enhanced reperfusion. J Thorac Cardiovasc Surg 2001; 121: 570–9
  • Vassiliades T. A., Nielsen J. L., Lonquist J. L. Coronary perfusion methods during off‐pump coronary bypass: results of a randomized clinical trial. Ann Thorac Surg 2002; 74: 1383–9
  • Laude K., Thuillez C., Richard V. Coronary endothelial dysfunction after ischemia and reperfusion: a new therapeutic target?. Braz Med Biol Res 2001; 34: 1–7
  • Nakamura K., Schmidt I., Gray C. C., et al. The effect of chronic L‐arginine administration on vascular recovery following cold cardioplegic arrest in rats. Eur J Cardiothorac Surg 2002; 21: 753–9
  • Gray C. C., Amrani M., Yacoub M. H. Heat stress proteins and myocardial protection: experimental model or potential clinical tool?. Int J Biochem Cell Biol 1999; 31: 559–73
  • Kim K. B., Lim C., Ahn H., Yang J. K. Intra‐aortic balloon pump therapy facilitates posterior vessel off‐pump coronary artery bypass grafting in high‐risk patients. Ann Thorac Surg 2001; 71: 1964–8
  • Patel N. C., Patel N. U., Loulmet D. F., McCabe J. C., Subramanian V. A. Emergency conversion to cardiopulmonary bypass during attempted off‐pump revascularisation results in increased morbidity and mortality. J Thorac Cardiovasc Surg 2004; 128: 655–61
  • Edgerton J. R., Dewey T. M., Magee M. J., et al. Conversion in off‐pump coronary artery bypass grafting: An analysis of predictors and outcomes. Ann Thorac Surg 2003; 76: 1138–43
  • Vassiliades T. A., Nielsen J. L., Lonquist J. L. Hemodynamic collapse during off‐pump coronary artery bypasses grafting. Ann Thorac Surg 2002; 73: 1874–9
  • Sinclair M. C., Wilsker G. A., Morris D. L., Mohan R., Hollenbeak C. S. Coronary artery bypass: the increasing role of off‐pump surgery in a large community hospital. Heart Surg Forum 2002; 5: 130–44
  • Iaco A. L., Contini M., Teodori G., et al. Off or on bypass: what is the safety threshold. Ann Thorac Surg 1999; 58: 1486–9
  • Anyanwu A. C., Al‐Ruzzeh S. A., George S. J., Patel R., Yacoub M. H., Amrani M. Conversion to off‐pump coronary bypass without increased morbidity or change in practice. Ann Thorac Surg 2002; 73: 798–802
  • Baumgartner F. J., Cheissari A., Capouya E. R., Panagiotides G. P., Katouzian A., Yokoyama T. Technical aspects of total revascularisation in off‐pump coronary bypass via sternotomy approach. Ann Thorac Surg 1999; 67: 1653–8
  • Soltoski P., Salerno T., Levinsky L., et al. Conversion to cardiopulmonary bypass in off‐pump coronary artery bypass grafting: its effect on outcome. J Card Surg 1998; 13: 328–34
  • Jegaden O., Mikaeloff. Off‐pump coronary artery bypass surgery. The beginning of the end?. Eur J Cardiothoracic Surg 2001; 19: 237–8
  • Detter C., Deuse T., Christ F., Boehm D. H., Reichenspurner H., Reichart B. Comparison of two stabilizer concepts for off‐pump coronary artery bypass grafting. Ann Thorac Surg 2002; 74: 497–501
  • Kim K. B., Lim C., Lee C., et al. Off‐pump coronary artery bypass may decrease the patency of saphenous vein grafts. Ann Thorac Surg 2001; 72: 1033–7
  • Lund O., Christensen J., Holme S., et al. On‐pump versus off‐pump coronary artery bypass: independent risk factors and off‐pump patency. Eur J Cardiothorac Surg 2001; 20: 901–7
  • Ömeroğlu S. N., Kirali K., Güler M., Toker M. E., İpek G., Işık Öyakut C. Midterm angiographic assessment of coronary artery bypass grafting without cardiopulmonary bypass. Ann Thorac Surg 2000; 70: 844–50
  • Jatene F. B., Pêgo‐Fernandes P. M., Hueb A. C., et al. Angiographic evaluation of graft patency in minimally invasive direct coronary artery bypass grafting. Ann Thorac Surg 2000; 70: 1066–9
  • Puskas J. D., Thourani V. H., Marshall J. J., et al. Clinical outcomes, angiographic patency, and resource utilization in 200 consecutive off‐pump coronary bypass patients. Ann Thorac Surg 2001; 71: 1477–84
  • Kleisli T., Cheng W., Jacobs M. J., et al. In the current era, complete revascularisation improves survival after coronary artery bypass surgery. J Thorac Cardiovasc Surg 2005; 129: 1283–91
  • Puskas J. D., Williams W. H., Duke P. G., et al. Off‐pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: a prospective randomized comparison of two hundred unselected patients undergoing off‐pump versus conventional coronary artery bypass grafting. J Thorac Cardiovasc Surg 2003; 125: 797–808
  • Bull D. A., Neumayer L. A., Stringham J. C., Meldrum P., Affleck D. G., Karwnande S. V. Coronary artery bypass grafting with cardiopulmonary bypass versus off‐pump cardiopulmonary bypass grafting: does eliminating the pump reduce morbidity and cost?. Ann Thorac Surg 2001; 71: 170–5
  • Sabik J. F., Gillinov A. M., Blackstone E. H., et al. Does off‐pump coronary surgery reduce morbidity and mortality?. J Thorac Cardiovasc Surg 2002; 124: 698–707
  • Buffolo E. Why is off‐pump coronary artery bypass grafting better?. Heart Surg Forum 2002; 5: 154–6
  • Arom K. V., Flavin T. F., Emery R. W., Kshettry V. R., Janey P. A., Petersen R. J. Safety and efficacy of off‐pump coronary artery bypass grafting. Ann Thorac Surg 2000; 69: 704–10
  • Cleveland J. C., Shroyer A. L. W., Chen A. Y., Peterson E., Grover F. L. Off‐pump coronary artery bypass grafting decreases risk‐adjusted mortality and morbidity. Ann Thorac Surg 2001; 72: 1282–9
  • Yokoyama T., Baumgartner F. J., Gheissari A., Capouya E. R., Panagiotides G. P., Declusin R. J. Off‐pump versus on‐pump coronary bypass in high‐risk subgroups. Ann Thorac Surg 2000; 70: 1546–50
  • Prifti E., Bonacchi M., Giunti G., et al. Does on‐pump/beating‐heart coronary artery bypass grafting offer better outcome in end‐stage coronary artery disease patients?. J Card Surg 2000; 15: 403–10
  • Larsson S., Nilsson F. A method for surgical exposure of intramyocardial coronary arteries for bypass grafting. Scand J Thorac Cardiovasc Surg 1998; 22: 47–9
  • Stamou S. C., Corso P. J. Coronary revascularisation without cardiopulmonary bypass in high risk patients: A route to the future. Ann Thorac Surg 2001; 71: 1056–61
  • Stamou S. C., Pfister A. J., Dangas G., et al. Beating heart versus conventional single vessel reoperative coronary artery bypass surgery. Ann Thorac Surg 2000; 69: 1383–7
  • Mohr R., Moshkovitz Y., Gurevitch J., Benetti F. J. Reoperative coronary artery bypass without cardiopulmonary bypass. Ann Thorac Surg 1997; 63: 40–3
  • Stamou S. C., Bafi A. S., Boyce S. W., et al. Coronary revascularisation of the circumflex: different approaches and outcomes. Ann Thorac Surg 2000; 70: 1371–7
  • Talwalker N. G., Cooley D. A., Ott D. A., Livesay J. J. Limited access coronary artery bypass grafting. The Texas Heart Institute experience. Tex Heart Inst J 1998; 25: 175–80
  • Jain U. Myocardial injury during reoperation for coronary artery bypass surgery. J Cardiothorac Vasc Anesth 1995; 9: 389–94
  • Koutlas T. C., Elbeery J. R., Williams J. M., et al. Myocardial revascularisation in the elderly using beating heart coronary artery bypass surgery. Ann Thorac Surg 2000; 69: 1042–7
  • Ricci M., Karamanoukian H. L., Abraham R., et al. Stroke in octogenarians undergoing coronary artery surgery with or without cardiopulmonary bypass. Ann Thorac Surg 2000; 69: 1471–5
  • Stamou S. C., Pfister A. J., Dullum M. K. C., et al. Beating heart versus conventional coronary artery bypass grafting in octogenarians: early clinical outcomes. J Am Coll Cardiol 2000; 35: 341
  • Boyd W. D., Desai N. D., Del Rizzo D. F., Novick R. J., Mckenzie F. N., Menkis A. H. Off‐pump surgery decreases postoperative complications and resource utilization in the elderly. Ann Thorac Surg 1999; 68: 1490–3
  • O'Connor G. T., Plume S. K., Olmstead E. M., et al. Multivariate prediction of in‐hospital mortality associated with coronary artery bypass graft surgery. Northern New England Cardiovascular Disease Study Group. Circulation 1992; 85: 2110–8
  • Akins C. W., Boucher C. A., Pohost G. M. Preservation of interventricular septal function in patients having coronary artery bypass grafts without cardiopulmonary bypass. Am Heart J 1984; 107: 304–9
  • Dipla K., Mattiello J. A., Jeevanandam V., Houser S. R., Margulies K. B. Myocyte recovery after mechanical circulatory support in humans with end‐stage heart failure. Circulation 1998; 97: 2316–22
  • Tasdemir O., Vural K. M., Karagoz H., Bayazit K. Coronary artery bypass grafting on the beating heart without the use of extracorporeal circulation: review of 2052 cases. J Thorac Cardiovasc Surg 1998; 116: 68–73
  • Patel N. C., Deodhar A. P., Grayson A. D., et al. Neurological outcomes in coronary surgery: independent effect of avoiding cardiopulmonary bypass. Ann Thorac Surg 2002; 74: 400–5
  • Diegeler A., Hirsch R., Schneider F., et al. Neuro monitoring and neuroprotective outcome in off‐pump versus conventional coronary bypass operation. Ann Thorac Surg 2002; 69: 1162–6
  • Lloyd C. T., Ascione R., Underwood M. J., Gardner F., Black A., Angelini G. D. Serum S‐100 protein release and neuropsychologic outcome during coronary revascularisation on the beating heart: a prospective randomized study. J Thorac Cardiovasc Surg 2000; 119: 148–54
  • Athanasiou T., Al‐Ruzzeh S., Kumar P., Crossman M. C., Amrani M., Pepper J. R., et al. Off‐pump myocardial revascularization is associated with less incidence of stroke in elderly patients. Ann Thorac Surg 2004; 77: 745–53
  • Athanasiou T., Aziz O., Mangoush O., Weerasinghe A., Al‐Ruzzeh S., Purkayastha S., et al. Do off‐pump techniques reduce the incidence of postoperative atrial fibrillation in elderly patients undergoing coronary artery bypass grafting?. Ann Thorac Surg 2004; 77: 1567–74
  • Taggart D. Off‐pump surgery and cerebral injury. J Thorac Cardiovasc Surg 2004; 127: 7–9
  • Bucerius J., Gummert J. F., Borger M. A., Walther T., Doll N., Falk V., et al. Predictors of delirium after cardiac surgery delirium: effect of beating‐heart (off‐pump) surgery. J Thorac Cardiovasc Surg 2004; 127: 57–64
  • Plasse H. M., Spencer F. C., Mittleman M., Frost J. O. Unilateral sudden loss of hearing: an unusual complication of cardiac operation. J Thorac Cardiovasc Surg 1980; 79: 822–6
  • Cox III A. J., Sergeant E. W. Sudden sensorineural hearing loss following nonotologic, noncardiopulmonary bypass surgery. Arch Otolaryngol Head Neck Surg 1997; 123: 994–8
  • Shapiro M. J., Purn J. M., Raskin C. A study of the effects of cardiopulmonary bypass surgery on auditory function. Laryngoscope 1981; 91: 2046–52
  • Aytacoglu B. N., Ozcan C., Sucu N., et al. Hearing loss in patients undergoing coronary artery bypass grafting with or without extracorporeal circulation. Med Sci Monit 2006; 12: 253–9
  • Elahi M., Hadjinikalau L., Galiñanes M. Incidence and clinical consequences of atrial fibrillation within 1 year of first‐time isolated coronary bypass surgery. Circulation 2003; 108: 207–12
  • Athanasiou T., Aziz O., Mangoush O., et al. Do off‐pump techniques reduce the incidence of postoperative atrial fibrillation in elderly patients undergoing coronary artery bypass grafting?. Ann Thorac Surg 2004; 77: 1567–74
  • Angelini G. D., Taylor F. C., Reeves B. C., et al. Early and midterm outcome after off‐pump and on‐pump surgery in Beating Heart Against Cardioplegic Arrest Studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. Lancet 2002; 359: 1194–9
  • Nathoe H. M., van Dijk D., Jansen E. W., et al. A comparison of on‐pump and off‐pump coronary bypass surgery in low‐risk patients. N Engl J Med 2003; 348: 394–402
  • Khan N. E., De Souza A., Mister R., et al. A randomized comparison of off‐pump and on‐pump multivessel coronary‐artery bypass surgery. N Engl J Med 2004; 350: 21–8
  • Legare J. F., Buth K. J., King S., et al. Coronary bypass surgery performed off pump does not result in lower in‐hospital morbidity than coronary artery bypass grafting performed on pump. Circulation 2004; 109: 887–92
  • Cleveland J. C., Shroyer A. L., Chen A. Y., et al. Off‐pump coronary artery bypass grafting decreases risk‐adjusted mortality and morbidity. Ann Thorac Surg 2001; 72: 1282–8
  • Calafiore A. M., Di Mauro M., Contini M., et al. Myocardial revascularisation with and without cardiopulmonary bypass in multivessel disease: impact of the strategy on early outcome. Ann Thorac Surg 2001; 72: 456–62
  • Al‐Ruzzeh S., Nakamura K., Athanasiou T., et al. Does off‐pump coronary artery bypass (OPCAB) surgery improve the outcome in high‐risk patients? A comparative study of 1398 high‐risk patients. Eur J Cardiothorac Surg 2003; 23: 50–5
  • Plomondon M. E., Cleveland J. C, Jr., Ludwig S. T., et al. Off‐pump coronary artery bypass is associated with improved risk‐adjusted outcomes. Ann Thorac Surg 2001; 72: 114–9
  • Magee M. J., Jablonski K. A., Stamou S. C., et al. Elimination of cardiopulmonary bypass improves early survival for multivessel coronary artery bypass patients. Ann Thorac Surg 2002; 73: 1196–203
  • Subramanian V. A. Less invasive arterial CABG on a beating heart. Ann Thorac Surg 1997; 111: 554–5
  • Gundry S. R., Romano M. A., Shattuck O. H., Razzouk A. J., Bailey L. L. Seven year follow up of coronary artery bypasses performed with or without cardiopulmonary bypass. J Thorac Cardiovasc Surg 1998; 115: 1273–8
  • Mehran R., Dangas G. D., Stamou C., et al. One‐year clinical outcome after minimally invasive direct coronary artery bypass. Circulation 2000; 102: 2799–802
  • Quigley R. L., Weiss S. J., Highbloom R. Y., Pym J. Creative arterial bypass can be performed on the beating heart. Ann Thorac Surg 2001; 72: 793–7
  • Kobayashi J., Sasako Y., Bando K., et al. Multiple off‐pump coronary revascularization with ‘aorta no‐touch’ technique using composite and sequential methods. Heart Surg Forum 2002; 5: 114–8
  • Cooper W. A., Corvera J. S., Thourani V. H., et al. Perfusion‐assisted direct coronary artery bypass provides early reperfusion of ischemic myocardium, and facilitates complete revascularization. Ann Thorac Surg 2003; 75: 1132–9

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