Off-pump coronary artery surgery
Off-pump coronary artery surgery
Cardiopulmonary bypass has several associated deleterious effects that include a systemic inflammatory response, coagulopathy, central nervous system complications and a variable degree of end-organ damage. The recent upsurge in interest in 'beating-heart' surgery attempts to avoid these deleterious effects. Advances in surgical technique, such as the use of intracoronary shunts and the Octopus retractor, have made beating-heart surgery a reality. The challenges for the anaesthetist are greater than for coronary artery surgery using cardiopulmonary bypass, and whilst some advantages are proven, such as the lack of the inflammatory response and the decreased need for blood or blood products, others have yet to be proved and there is a need for further research. The advantages and disadvantages need to be evaluated in randomised studies in order to confirm the safety and efficacy of these new techniques in terms of long-term graft patency and decreased morbidity.
anaesthesia, cardiovascular, surgery
676-685
Heames, R. M.
e9a2435a-4f22-4026-a892-3fc086a3f119
Gill, R. S.
c96c958f-5539-483c-a878-68af5e0196fd
Ohri, S. K.
8aa5698c-78cf-4f59-a5af-5afa46f0348c
Hett, D. A.
c538069a-ce97-48f5-943d-fca3191b123e
2002
Heames, R. M.
e9a2435a-4f22-4026-a892-3fc086a3f119
Gill, R. S.
c96c958f-5539-483c-a878-68af5e0196fd
Ohri, S. K.
8aa5698c-78cf-4f59-a5af-5afa46f0348c
Hett, D. A.
c538069a-ce97-48f5-943d-fca3191b123e
Abstract
Cardiopulmonary bypass has several associated deleterious effects that include a systemic inflammatory response, coagulopathy, central nervous system complications and a variable degree of end-organ damage. The recent upsurge in interest in 'beating-heart' surgery attempts to avoid these deleterious effects. Advances in surgical technique, such as the use of intracoronary shunts and the Octopus retractor, have made beating-heart surgery a reality. The challenges for the anaesthetist are greater than for coronary artery surgery using cardiopulmonary bypass, and whilst some advantages are proven, such as the lack of the inflammatory response and the decreased need for blood or blood products, others have yet to be proved and there is a need for further research. The advantages and disadvantages need to be evaluated in randomised studies in order to confirm the safety and efficacy of these new techniques in terms of long-term graft patency and decreased morbidity.
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Published date: 2002
Keywords:
anaesthesia, cardiovascular, surgery
Identifiers
Local EPrints ID: 25603
URI: http://eprints.soton.ac.uk/id/eprint/25603
ISSN: 0003-2409
PURE UUID: edd0339a-ee53-4870-8c67-25a0b97f95e2
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Date deposited: 11 Apr 2006
Last modified: 15 Mar 2024 07:03
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Author:
R. M. Heames
Author:
R. S. Gill
Author:
S. K. Ohri
Author:
D. A. Hett
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