Emergency conversion to cardiopulmonary bypass in off-pump coronary artery bypass grafting is recognized to increase operative mortality and morbidity. We conducted a retrospective review of 616 consecutive patients who were planned for off-pump coronary artery bypass grafting from April 2001 to July 2004. Fourteen patients (2.3%) required emergency conversion to cardiopulmonary bypass. Operati...

Hereditary angioedema (HAE) is an autosomal dominantly inherited deficiency of C1-inhibitor, and it is an extremely rare condition. During surgery, oedema can be induced by a variety of stresses, and a high mortality rate has been reported. Since open-heart surgery involves cardiopulmonary bypass, the inflammatory response and complement activity are increased, meaning that an even greater risk...

PURPOSE We assessed the feasibility of systematic off-pump coronary artery bypass (OPCAB) and identified risk factors for on-pump conversion. METHODS Between July 1, 2002 and December 31, 2003, OPCAB was attempted for all patients who required isolated coronary artery bypass in our institution. The perioperative results of patients were prospectively entered into a structured database, the re...

OBJECTIVES Patients undergoing coronary bypass grafting (CABG) are at higher risk if they suffer from atrial fibrillation (AF). It was suggested that performing CABG without the use of cardiopulmonary bypass (off-pump) would reduce perioperative risk. We assessed the influence of preoperative AF on outcome in a randomized cohort of patients above the age of 75 undergoing either on-pump or off-p...

 ABSTRACT Background: Aprotinin has been used increasingly to reduce postoperative blood loss in open-heart operations due to the potentialities for complications and high cost, it would seem reasonable to use aprotinin more selectively in small doses in the prime solution of the pump. Methods: We prospectively studied the effect of preoperative low dose aprotinin [2 million units (230mg)] on b...

INTRODUCTION AND OBJECTIVES The transient myocardial ischemia that occurs during cardiac surgery leads to oxidative stress and the production of free radicals. The resulting damage can be reduced if cardiopulmonary bypass is avoided. We obtained indirect measures of the oxidative damage occurring during cardiac surgery by monitoring the glutathione system and we studied the influence of cardiop...

Afilalo and colleagues have presented an updated meta-analysis and meta-regression of randomized trials of off-pump vs. on-pump coronary artery bypass grafting (CABG) surgery. Their two major findings are that while there was a reduction in mortality, myocardial infarction, and stroke in the off-pump group, this only reached significance for the latter, and that the effect of off-pump CABG was ...

Coronary Artery Surgery To the Editor: Van Dijk and colleagues1 are to be congratulated on the contribution of their randomized trial to the on-pump versus off-pump coronary artery bypass surgery debate and, in particular, the discussion of the high proportion of patients undergoing total arterial revascularization. Most of the pertinent points are covered in Dr Yacoub’s balanced accompanying e...

OBJECTIVES The changes in the serum levels of lipopolysaccharide binding protein (LBP) and sCD14 during cardiac surgery were followed in this study. DESIGN Thirty-four patients, 17 in each group, were randomly assigned to coronary artery bypass grafting surgery performed either with ("on-pump") or without ("off-pump") cardiopulmonary bypass. LBP and sCD14 were evaluated by ELISA. RESULTS Th...