The Past, Present, and Future of Off-Pump Coronary Artery Bypass Grafting

April 16, 2025 No Comments

This review traces the evolution and prospects of off-pump coronary artery bypass grafting (OPCAB). Despite early skepticism due to technical difficulty, OPCAB offers major advantages for high-risk patients, including reduced stroke risk and faster recovery. Modern trials and meta-analyses show comparable or superior outcomes to on-pump CABG when performed by experienced surgeons. Emphasis is placed on arterial grafting, no-touch techniques, and hybrid strategies for future optimization.

Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury in On-pump Cardiac Surgery—A Post-hoc Analysis of a Randomized Clinical Trial

April 1, 2025 No Comments

A post-hoc analysis of the ALBICS randomized trial with 1,386 cardiac surgery patients found that perioperative bleeding, as classified by the Universal Definition of Perioperative Bleeding (UDPB), was not independently linked to acute kidney injury (AKI). Rather, bleeding indirectly contributed to AKI through hypotension and fluid overload. The only transfusion product independently associated with AKI was fresh frozen plasma.

Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

March 15, 2025 No Comments

This study examines the impact of gradual oxygen exposure during emergency coronary bypass surgery for acute myocardial infarction (MI). A retrospective cohort of 66 patients was analyzed, comparing outcomes between those receiving venous blood cardioplegia with controlled oxygen exposure and those undergoing standard hyperoxic procedures. The findings indicate a significant reduction in mortality, improved ventricular function, lower readmission rates for heart failure, and reduced need for defibrillators.

The Role of Impella in the Pre-Procedural Management of Post-Infarct Ventricular Septal Defect: A Systematic Review

December 17, 2024 No Comments

This systematic review explores the use of the Impella device in patients with post-infarct ventricular septal defect (VSD) prior to definitive treatment. Analyzing 68 patients across 20 studies, the Impella improved hemodynamic stability, reduced left ventricular strain, and delayed urgent intervention. Patients with surgically-placed Impella devices showed lower mortality and fewer complications compared to percutaneous alternatives. While effective, complications like bleeding and hemolysis must be carefully managed.

Meta-Analysis Comparing Immediate Versus Staged Complete Revascularization for ST-Elevation Myocardial Infarction With Multivessel Disease

December 17, 2024 No Comments

This meta-analysis compares immediate versus staged complete revascularization (CR) in ST-elevation myocardial infarction (STEMI) patients with multivessel disease. Analyzing five randomized controlled trials (1,415 patients), no significant difference was observed in major adverse cardiovascular events (MACE), mortality, or myocardial infarction rates. However, staged CR showed a higher rate of unplanned ischemia-driven revascularization. Timing of staged intervention is crucial for optimized outcomes.

Differences in Plasma Extracellular Vesicles of Different Origin in On-Pump Versus Off-Pump Cardiac Surgery

December 8, 2024 No Comments

This study compares the immune responses of patients undergoing coronary artery bypass grafting (CABG) via on-pump and off-pump methods. On-pump CABG induced a more significant immune response, with notable increases in extracellular vesicles (EVs) derived from platelets, endothelial cells, and B-cells. Off-pump surgery was associated with milder changes in cytokine and EV profiles. Findings highlight EVs’ role in regulating postoperative inflammation and suggest a potential mechanism for immune modulation.

The Value of Off-Pump Coronary Artery Bypass Grafting in Surgery for Combined Valvular and Coronary Heart Disease

December 8, 2024 No Comments

This study explores the benefits of off-pump coronary artery bypass grafting (OPCABG) in surgeries combining valve and coronary interventions. Among 884 patients, the OPCABG group showed reduced incidences of postoperative atrial fibrillation (29.5% vs. 39.5%) and acute kidney injury (14.5% vs. 21.2%) compared to on-pump CABG. No differences in mortality or stroke rates were observed. The results suggest OPCABG is a safe and effective approach for improved short-term outcomes in complex cardiac surgeries.

Gradual Reperfusion in Cardioplegia-Induced Cardiac Arrest

November 3, 2024 No Comments

This study explores the potential benefits of gradual reperfusion in cardiac surgery patients experiencing cardioplegia-induced cardiac arrest, aiming to reduce ischemia-reperfusion injury. Fifty elective cardiac surgery patients were randomized into two groups: a hyperoxemic control group with conventional reoxygenation and a normoxemic study group with gradual reoxygenation. Results showed that gradual reperfusion was safe but did not significantly reduce ischemia-reperfusion injury compared to standard methods, although potassium levels were lower in the normoxemic group.

Risk Factors of Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting Surgery in the Recent 10 Years: Clinical Analysis of 6229 Patients

October 22, 2024 No Comments

This retrospective study analyzed 6,229 patients who underwent isolated coronary artery bypass grafting (CABG) from 2015 to 2023 to determine the risk factors for postoperative atrial fibrillation (POAF). The incidence of POAF was 30.94%. Univariate analysis revealed factors such as age, hypertension, smoking, CPB time, and ejection fraction (EF) as significant. Multivariate analysis identified older age and low EF as independent risk factors for POAF.

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

October 15, 2024 No Comments

Acute kidney injury (AKI) is a common complication following cardiac surgeries like coronary artery bypass grafting (CABG). This study analyzed 120 patients to identify risk factors for AKI, which occurred in 26% of the cases. Findings showed that patients with higher EuroSCORE II values, elevated creatinine and urea levels, lower hemoglobin, and reduced oxygen delivery during cardiopulmonary bypass (CPB) were more likely to develop AKI. AKI was also linked to longer hospital stays.

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The Past, Present, and Future of Off-Pump Coronary Artery Bypass Grafting

Perioperative Bleeding Is Not an Independent Risk Factor for Acute Kidney Injury in On-pump Cardiac Surgery—A Post-hoc Analysis of a Randomized Clinical Trial

Gradual Oxygen Exposure During Coronary Bypass for Acute Myocardial Infarction: A Retrospective Cohort Study

The Role of Impella in the Pre-Procedural Management of Post-Infarct Ventricular Septal Defect: A Systematic Review

Meta-Analysis Comparing Immediate Versus Staged Complete Revascularization for ST-Elevation Myocardial Infarction With Multivessel Disease

Differences in Plasma Extracellular Vesicles of Different Origin in On-Pump Versus Off-Pump Cardiac Surgery

The Value of Off-Pump Coronary Artery Bypass Grafting in Surgery for Combined Valvular and Coronary Heart Disease

Gradual Reperfusion in Cardioplegia-Induced Cardiac Arrest

Risk Factors of Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting Surgery in the Recent 10 Years: Clinical Analysis of 6229 Patients

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

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