Current randomized control trials, observational studies and meta analysis in off-pump coronary surgery

Journal of Cardiothoracic Surgery

Peter Mhandu¹  Reza Al-Saudi¹  Victoria Graham¹  Savvas Lampridis¹  Mondrian Parissis¹  Man Chi Lau¹  Haralabos Parissis¹ 

[1] Cardiothoracic Department, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, UK & Northern Ireland

关键词: Off-pump versus on-pump;    RCTs in off-pump surgery;    beating heart surgery;    Coronary artery bypass surgery;    Off-pump coronary surgery;   

Others  :  1235240
DOI  :  10.1186/s13019-015-0391-x

 received in 2015-03-28, accepted in 2015-12-08,  发布年份 2015

【 摘 要 】

The off-pump literature is divided into three eras: the “early phase” with results favouring off-pump surgery supported with randomized control trials (RCTs) mainly from Bristol, UK; an “intermediate phase” dominated by the results of the ROOBY trial and finally a more “contemporary phase” whereby the off/on-pump argument is unsettled. Although the literature has failed to project an overall superiority of off-pump versus on-pump surgery, nevertheless, small randomized control trials and large meta-analysis studies are concluding that the incidence of a stroke is less than 1 % when an aortic off-pump techniques (especially the non-touch technique) are advocated in patients with diseased ascending aorta. Furthermore, off-pump combined with hybrid procedures may lead to a reduction of adverse outcome in the aged high-risk population with concomitant poor left ventricular function and co-morbidities.

The current review attempts to bring an insight onto the last ten years knowledge on the on/off-pump debate, with an aim to draw some clear conclusions in order to allow practitioners to reflect on the subject.

【 授权许可】

   
2015 Parissis et al.

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