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Ann Thorac Surg 2001;71:1056-1061
© 2001 The Society of Thoracic Surgeons

Current review

Coronary revascularization without cardiopulmonary bypass in high-risk patients: a route to the future

Sotiris C. Stamou, MD, PhDa, Paul J. Corso, MDa

a Section of Cardiac Surgery, Department of Surgery, Washington Hospital Center, Washington, DC, USA

Address reprint requests to Dr Corso, Section of Cardiac Surgery, Washington Hospital Center, 106 Irving St NW, Suite 316, South Tower, Washington, DC 20010
e-mail: pjc1{at}mhg.edu

Previous reports have demonstrated that reoperative coronary revascularization, advanced age, female sex, and impaired left ventricular dysfunction are independent predictors of operative mortality after coronary artery bypass grafting (CABG). CABG without cardiopulmonary bypass (off-pump CABG) has been proposed as a potential therapeutic alternative in these high-risk patient groups. Despite the substantial learning curve associated with off-pump CABG, early outcomes of off-pump CABG in high-risk patients are better than those associated with the conventional on-pump CABG approach. These results suggest that off-pump CABG is a safe alternative to on-pump CABG in high-risk patients. Randomized prospective studies are needed to validate the results of these initial retrospective reports and to demonstrate the long-term benefits of this approach.




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