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

Abstract: 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.

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