Patient selection and technical considerations for off-pump coronary surgery.

摘要: The first successful operations on the coronary arteries were done without assistance of extracorporeal circulation. Many published reports described performed while heart continued beating (1–8). Advances in cardiopulmonary bypass (CPB) technology, myocardial protection, and support allowed surgeons to operate these with greater precision. It is widely accepted that single most important development cardiac surgery was introduction refinement circulation via CPB. Event-free survival rates dramatically improved advancements protection operating a quiet, motionless, bloodless field. More recently, advances 2 competing strategies, artery grafting (CABG) catheter-based intervention, have led many debates regarding optimal treatment ischemic disease. CABG has resulted longer survival, better quality life, long-term event-free patients multivessel disease (9–11). But what old new again. option not using pump underlying assumption concept minimally invasive surgery. Reports systemic effects CPB abound literature past 17 years. Such include hematologic, metabolic, pulmonary, cardiac, cognitive dysfunctions (12–21).