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Ann Thorac Surg 2000;69:785-791
© 2000 The Society of Thoracic Surgeons


Original Articles

Off-pump bypass graft operation significantly reduces oxidative stress and inflammation

Bashir M. Matata, PhDa, Andrzej W. Sosnowski, MDa, Manuel Galiñanes, FRCSa

a Division of Cardiac Surgery, Department of Surgery, University of Leicester, Glenfield Hospital, Leicester, United Kingdom

Address reprint requests to Dr Galiñanes, Division of Cardiac Surgery, Department of Surgery, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, United Kingdom
e-mail: mg50{at}le.ac.uk

Background. This study investigated whether off-pump coronary bypass graft operations on the beating heart under normothermic conditions reduces the systemic oxidative stress and inflammatory reaction seen in patients operated under cardiopulmonary bypass (CPB).

Methods. A cardiac stabilizer (Octopus Tissue Stabilizer; Medtronic Inc, Minneapolis, MN) was used to perform the coronary anastomoses on the normothermic beating heart with or without CPB. Serial blood samples were taken at various intervals. Plasma was analyzed for several oxidative stress and inflammatory markers.

Results. Significant increases from prior anesthesia values of lipid hydroperoxides (190% at 4 hours), protein carbonyls (250% at 0.5 hours) and nitrotyrosine (510% at 0.5 hours) were seen in the CPB group, but they were abolished or significantly reduced in the off-pump group. Complement C3a and elastase levels were rapidly increased upon the institution of CPB, and this was followed by increases in IL-8, TNF-{alpha}, and sE-selectin. In contrast, the rise of these factors was blunted in patients operated without CPB.

Conclusions. Off-pump coronary bypass graft operation on a beating heart significantly reduces oxidative stress and suppresses the inflammatory reaction associated with the use of CPB.




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Ann. Thorac. Surg.Home page
R. L. Quigley, S. J. Weiss, R. Y. Highbloom, and J. Pym
Creative arterial bypass grafting can be performed on the beating heart
Ann. Thorac. Surg., September 1, 2001; 72(3): 793 - 797.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
G. Asimakopoulos
Systemic inflammation and cardiac surgery: an update
Perfusion, September 1, 2001; 16(5): 353 - 360.
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Ann. Thorac. Surg.Home page
K.-B. Kim, C. Lim, C. Lee, I.-H. Chae, B.-H. Oh, M.-M. Lee, and Y.-B. Park
Off-pump coronary artery bypass may decrease the patency of saphenous vein grafts
Ann. Thorac. Surg., September 1, 2001; 72(3): S1033 - 1037.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
F. M. Azoury, A. M. Gillinov, B. W. Lytle, N. G. Smedira, and J. F. Sabik
Off-pump reoperative coronary artery bypass grafting by thoracotomy: patient selection and operative technique
Ann. Thorac. Surg., June 1, 2001; 71(6): 1959 - 1963.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
K.-B. Kim, C. Lim, H. Ahn, and J.-K. Yang
Intraaortic balloon pump therapy facilitates posterior vessel off-pump coronary artery bypass grafting in high-risk patients
Ann. Thorac. Surg., June 1, 2001; 71(6): 1964 - 1968.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
S. C. Stamou and P. J. Corso
Coronary revascularization without cardiopulmonary bypass in high-risk patients: a route to the future
Ann. Thorac. Surg., March 1, 2001; 71(3): 1056 - 1061.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
J. M Toomasian and W. Aboul-Hosn
Coronary artery bypass grafting using a miniature right ventricular support system
Perfusion, December 1, 2000; 15(6): 521 - 526.
[Abstract] [PDF]




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