Abstract
Avoiding the morbidity of cardiopulmonary bypass should theoretically reduce the incidence of organ dysfunction and lead to improved patient outcomes. Recently, cardiac mechanical stabilization techniques were developed, facilitating on-pump CABG (OPCAB). The use of CPB may influence the economic outcome, while maintaining quality of care and patient satisfaction. MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), Science Citation Index (SCI), Current Contents, NHS Economic Evaluation Database (NEED), and International Network of Agencies for Health Technology Assessment (INAHTA) databases were searched from the date of their inception to the end of March 2008, using the search terms off-pump, minimally invasive, beating heart, coronary artery bypass, and their variants. Off-pump revascularization offers a safe, cost-effective alternative to conventional coronary revascularization with cardiopulmonary bypass (CABG) and cardioplegic arrest.
Highlights
Coronary artery bypass grafting was first performed without the use of cardiopulmonary bypass (CPB) in the late 1960s [1], but this technique was largely abandoned after the use of CPB and cardioplegic arrest became routine [2]
Off-pump coronary bypass emerged as a new refined technique that is thought to provide a safer form of surgical revascularization by avoiding the unwanted complications of cardiopulmonary bypass, in the increasingly complex patients being referred for operation [3]
Off-pump coronary artery bypass grafting is safe, reduces hospital cost, postoperative length of stay, decreased mortality and morbidity compared with CABG on cardiopulmonary bypass
Summary
Coronary artery bypass grafting was first performed without the use of cardiopulmonary bypass (CPB) in the late 1960s [1], but this technique was largely abandoned after the use of CPB and cardioplegic arrest became routine [2]. Off-pump coronary bypass emerged as a new refined technique that is thought to provide a safer form of surgical revascularization by avoiding the unwanted complications of cardiopulmonary bypass, in the increasingly complex patients being referred for operation [3]. The Octopus as cardiac stabilization techniques is one of the devices that can immobilize andpresent all sides of the beating heart [5]. This allows off-pump coronary artery bypass grafting (CABG) in patients with 3-vessel disease [3]. It has to be stated that the rate of incomplete revascularization in the early series of CABG without CPB is higher, and compromises the basic principle of complete revascularization [4].
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