Cognitive and cardiac outcomes 5 years after off-pump vs on-pump coronary artery bypass graft surgery.

Context: Conventional coronary artery bypass graft surgery with use of cardiopulmonary bypass (on-pump CABG) is associated with excellent long-term cardiac outcomes but also with a high incidence of cognitive decline. The effect of avoiding cardiopulmonary bypass (off-pump CABG) on long-term cognitive and cardiac outcomes is unknown.

Objective: To compare the effect of off-pump CABG and on-pump CABG surgery on long-term cognitive and cardiac outcomes.

Risk and determinants of myocardial injury during off-pump coronary artery bypass grafting.

Perioperative myocardial injury (PMI) after coronary revascularization (bypass surgery using cardiopulmonary bypass or percutaneous intervention) is strongly associated with future adverse events, such as death, myocardial infarction, and coronary intervention. The incidence, determinants, and prognostic significance of PMI after bypass surgery without cardiopulmonary bypass (off-pump surgery) are unknown. The study population comprised the patients who were randomized to off-pump surgery in the Octopus Study.

Role of coronary collaterals in off-pump and on-pump coronary bypass surgery.

Background: Collaterals limit infarct size, preserve viability, and reduce mortality in patients with acute myocardial infarction. In patients with stable coronary disease, collaterals are associated with less angina and ischemia during angioplasty and fewer ischemic events during follow-up. The role of collaterals has not been studied in patients undergoing off-pump or on-pump bypass surgery.

Meta-analysis on the effect of off-pump coronary bypass surgery.

Objective: To assess the effect of conventional coronary artery bypass surgery (CABG) compared to the off-pump procedure (OPCAB).

Methods: Based on randomised trials found in PubMed and Science Citation Index, an overall odds ratio and 95% confidence interval was calculated for the combined endpoint of mortality, stroke and myocardial infarction.

Results: The 18 randomised trials included 1584 patients (783 OPCAB, 801 CABG).

A comparison of on-pump and off-pump coronary bypass surgery in low-risk patients.

Background: The performance of coronary bypass surgery without cardiopulmonary bypass ("off pump") may reduce perioperative morbidity and costs, but it is uncertain whether the outcome is similar to that involving the use of cardiopulmonary bypass ("on pump").

Methods: In a multicenter, randomized trial, we randomly assigned 139 patients with predominantly single- or double-vessel coronary disease to on-pump surgery and 142 to off-pump surgery. Cardiac outcome and cost effectiveness were determined one year after surgery.

Cognitive outcome after off-pump and on-pump coronary artery bypass graft surgery: a randomized trial.

Context: Coronary artery bypass graft (CABG) surgery is associated with a decline in cognitive function, which has largely been attributed to the use of cardiopulmonary bypass (on-pump procedures). Cardiac stabilizers facilitate CABG surgery without use of cardiopulmonary bypass (off-pump procedures) and should reduce the cognitive decline associated with on-pump procedures.

Objective: To compare the effect of CABG surgery with (on-pump) and without (off-pump) cardiopulmonary bypass on cognitive outcome.