| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2001;72:1282-1289
© 2001 The Society of Thoracic Surgeons
a University of Colorado Health Sciences Center, Denver, Colorado, USA
b Denver Department of Veterans Affairs Medical Center, Denver, Colorado, USA
c Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
Address reprint requests to Dr Cleveland, Division of Cardiothoracic Surgery, University of Colorado Health Sciences Center, Box C-310, 4200 E Ninth Ave, Denver, CO 80262
e-mail: joseph.cleveland{at}uchsc.edu
Presented at the Forty-seventh Annual Meeting of the Southern Thoracic Surgical Association, Marco Island, FL, Nov 9–11, 2000.
 |
Abstract |
|---|
 TopFootnotes Abstract IntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
Methods. Using The Society of Thoracic Surgeons (STS) National Adult Cardiac Surgery Database, procedural outcomes were compared for conventional and off-pump CABG procedures from January 1, 1998, through December 31, 1999. Mortality and major complications were examined, both as unadjusted rates and after adjusting for known base line patient risk factors.
Results. A total of 126 experienced centers performed 118,140 total CABG procedures. The number of off-pump CABG cases was 11,717 cases (9.9% of total cases). The use of an off-pump procedure was associated with a decrease in risk-adjusted operative mortality from 2.9% with conventional CABG to 2.3% in the off-pump group (p < 0.001). The use of an off-pump procedure decreased the risk-adjusted major complication rate from 14.15% with conventional CABG to 10.62% in the off-pump group (p < 0.0001). Patients receiving off-pump procedures were less likely to die (adjusted odds ratio 0.81, 95% CI 0.70 to 0.91) and less likely to have major complications (adjusted odds ratio 0.77, 95% CI 0.72 to 0.82).
Conclusions. Off-pump CABG is associated with decreased mortality and morbidity after coronary artery bypass grafting. Off-pump CABG may prove superior to conventional CABG in appropriately selected patients.
|
Introduction |
|---|
|
TopFootnotesAbstractIntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
Proponents of operative coronary revascularization without cardiopulmonary bypass (off-pump CABG) cite these CPB-induced morbidities as a major advantage to performing CABG without extracorporeal circulation. However, early experience with beating heart coronary revascularization was limited to single center reports with a small number of patients. Although several reports suggested a reduction in morbidity after off-pump CABG [1, 2, 10–12], it is unknown whether off-pump CABG decreases the risk of death or major morbidity after coronary revascularization in a larger cohort of patients across multiple centers. Of great concern was the observation that early graft patency rates with off-pump CABG did not appear to match the excellent results obtained with conventional CABG [13–15]. Despite these graft patency issues, off-pump CABG has emerged as an option to conventional CABG for multivessel coronary revascularization.
The purpose of this study is to determine whether off-pump CABG in selected patients decreases risk-adjusted operative death and major perioperative complications in multiple institutions.
|
Material and methods |
|---|
|
TopFootnotesAbstractIntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
To avoid a potential bias of a learning curve associated with this new technical approach, this study population included only the subset of hospitals performing cardiac surgery that had substantive experience with off-pump procedures. Centers performing at least 20 off-pump procedures were included in the analysis, and these programs were thus designated as experienced for the purposes of this study.
The outcomes of care studied were 30-day operative death and 30-day complications. The major complications include stroke or coma, ventilator use of 24 hours or more, renal failure (50% or more increase in creatinine over base line or new requirement for dialysis), deep sternal infection (mediastinitis), and reoperation for bleeding. Operative death was defined as all deaths occurring during the hospitalization in which the operation was performed, even if after 30 days; and as those deaths occurring after discharge from the hospital but within 30 days of the procedure, unless the cause of death is clearly unrelated to the operation.
All statistical analyses were performed using SAS statistical software. First, the univariate relationship between risk factor and the two outcomes, operative death and complications, was examined. After the univariate analysis, multivariate analysis was used to control for potential confounding effects. Separate multiple logistic regression models were performed for both complications and operative death. Mortality models included all independent patient variables that have been found to be risk factors for mortality in previous modeling in the STS National Database (http://www.ctsnet.org/doc/4314). The same set of risk factors was also used to control for potential confounding effects for the complications model. Risk-adjusted mortality was defined as the ratio of observed mortality over expected mortality multiplied by overall patient mortality. An off-pump dichotomous variable was then added to the models to determine its significance after adjusting for covariates.
|
Results |
|---|
|
TopFootnotesAbstractIntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
Table 1 compares the preoperative risk factors between the conventional CABG and the off-pump patients within the 126 study hospitals. The off-pump patients were older, more likely to be female, and less likely to be diabetic than the conventional CABG group. Interestingly, the off-pump CABG group had a greater percentage of patients with preexisting COPD, dialysis-dependent renal failure, and cerebrovascular disease than the conventional CABG group. The conventional CABG group had a greater proportion of patients with three-vessel CAD compared to the off-pump group, and a greater percentage of patients in the conventional CABG group were classified as urgent or emergent cases.
|
|
|
|
|
|
|
|
|
Comment |
|---|
|
TopFootnotesAbstractIntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
Others have reported improved clinical outcomes after off-pump CABG. Arom and associates [12] reported outcomes in patients undergoing off-pump CABG and conventional CABG. They risk-adjusted their patients according to STS database models and found that overall operative mortality was similar between the two groups. Importantly, time on mechanical ventilation, reoperation for bleeding, perioperative MI, and new onset atrial fibrillation were all lowered in the off-pump CABG group. Furthermore, their data suggested that in the highest-risk group (estimated mortality > 10%), off-pump CABG substantially reduced mortality compared to conventional CABG. Our data similarly suggests that off-pump CABG reduces risk-adjusted postoperative mortality compared to conventional CABG across all risk groups (Table 3). Based on the results of the present study, we suggest that off-pump CABG may decrease mortality across a broad spectrum of patients. Although the observed-to-expected ratio of mortality for an off-pump procedure was 0.81, suggesting a 19% reduction in the likelihood of death, it is important to bear in mind that the absolute difference in mortality between the off-pump and conventional CABG cohorts was only 0.6% (2.94% to 2.32%).
Our data suggest that off-pump CABG may attenuate pulmonary dysfunction after CABG. Cardiopulmonary bypass has been associated with acute lung injury after CABG. Kochamba and colleagues [16] performed a prospective, randomized, controlled trial of off-pump versus conventional CABG and compared pulmonary indices postoperatively. Off-pump CABG improved postoperative pulmonary shunt, whereas time to extubation and the percentage of patients extubated less than 6 hours was not different between groups. When we examined the subgroup of patients in the STS Database with the preoperative risk factor of COPD, off-pump CABG resulted in fewer patients with prolonged mechanical ventilation postoperatively. Thus off-pump CABG may be an attractive alternative to conventional CABG in preventing pulmonary complications in patients with preidentified pulmonary disease.
Coronary artery bypass grafting with conventional CPB has also been associated with a decline in postoperative renal function. Ascione and colleagues [8] have investigated this change in renal function by randomizing patients to off-pump or conventional CABG. They found that GFR and renal tubular function declined substantially in conventional CABG compared to off-pump patients. Their study did not, however, document a difference in renal failure after either surgical strategy. The present study showed a protection against postoperative renal failure for off-pump CABG in the entire group of patients (Table 5). Interestingly, however, this protection against renal failure was not evident in the subgroup with base line creatinine values of more than 1.5 (Table 6). The explanation for the lack of difference in this higher risk subgroup is not clear, but the number of patients operated on in this study with base line creatinine values of more than 1.5 was very small, and small sample size could account for this observation.
Permanent neurologic dysfunction (stroke or coma) after conventional CABG is a devastating complication. Current data implicate conventional CABG with CPB as having a 3% to 4% rate of permanent CVA [19]. Our data suggest that off-pump CABG may protect against CVA. The observed-to-expected ratio from the multivariate analysis for off-pump CABG and stroke is 0.62 (Table 5). Furthermore, analyzing the subgroup with preoperative CVD suggests that off-pump CABG reduces the rate of postoperative CVA compared to conventional CABG (Table 6). Again, the absolute risk of stroke was reduced from 4.6% to 2.5%, a difference of 2.1%. Clearly, previous reports have identified preoperative CVD as a robust predictor of postoperative adverse neurologic events [6], and interventions to reduce this risk are necessary.
Conventional CABG with CPB activates the complement system and fibrinolysis [17]. In addition, CPB-induced platelet and coagulation factor abnormalities are well described. Our study agrees with others [2, 12, 18] who have documented less perioperative blood loss with off-pump CABG. Importantly, our data suggest that an off-pump strategy reduces the likelihood of reoperation for bleeding (Table 5). Although our data showed a decrease postprocedure length of stay with the off-pump CABG group, actual hospital resource use and overall cost savings were not able to be calculated in the present study.
The present study has several important limitations. The STS Database provides valuable, but retrospective, observational data. The potential for confounding variables is almost unlimited in observational retrospective studies. Patient selection for off-pump surgery, differences in surgical technique, experience of the group in performing on-pump versus off-pump procedures, and other differences between the on-pump and off-pump patients are important variables that certainly differed between these two groups. With regard to patient characteristics, the on-pump cohort had a greater number of preoperative risks factors such as urgent or emergent surgery, left main disease, lower ejection fraction, and preoperative use of an intraaortic balloon pump. The off-pump cohort differed substantially in that this group had more COPD, preoperative dialysis, more female patients, and greater age (Table 1). The number of bypass grafts placed in the on-pump group was greater than in the off-pump group (Table 2). Clearly, these two groups of patients differed substantially, and we suspect that a heavy selection bias guided certain patients toward either on-pump or off-pump operations. A yet-unanswered, important long-term outcome of off-pump CABG relates to vessel patency and freedom from reintervention. Our study could not examine either of these important endpoints, as these prospective events could not be captured by our retrospective analysis.
The pressure by cardiologists, patients, and others to perform off-pump CABG as an alternative to conventional CABG continues to increase. This study suggests that off-pump CABG may reduce postoperative mortality, morbidity, and length of stay. Furthermore, in subgroups with preexisting pulmonary or cerebrovascular disease, an off-pump strategy may reduce pulmonary or neurologic dysfunction, respectively, after CABG. The results of the present study are encouraging but mandate that prospective, randomized data should be accrued to confirm or refute our preliminary results. For the present, we suggest that off-pump CABG in selected patients may offer improved risk-adjusted outcomes when compared to conventional CABG.
|
Footnotes |
|---|
|
TopFootnotesAbstractIntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
|
Discussion |
|---|
|
TopFootnotesAbstractIntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
This study is the largest nonrandomized study so far. The statistics are sound and difficult to dispute. Your results have shown that off-pump coronary artery bypass surgery is better than on-pump in all the study variables. These findings are also similar to most of the articles that have been presented during the past two years and to our experience, which is nearing 1,000 off-pump cases at the present time. We have also observed that operative mortality is going down. The mortality in our group for off-pump coronary artery bypass surgery is approximately 1%.
I have two concerns about your presentation. My first concern is that 20 cases is too small a sample size for a learning curve. It took me much more than 20 cases before I became comfortable doing off-pump coronary artery bypass surgery. So, I feel if you allow surgeons to have more experience, it will be better for the off-pump group. My second concern is that you did not show us that you did complete revascularization. We need to know the number of grafts per patient and the number of grafts per site, which is not available in your report today.
Mister Chairman, about 70% of us are not doing off-pump CABG at the present time. One of the reasons is because we are waiting for the best preoperative randomized study. Does this paper answer our question? I would say no. Is this paper the best paper? Let me quote Bill Clinton’s analogy. He said, "Voting for Gore is voting for the next best economy." So I would say this is maybe the next best paper available before the randomized trial.
Doctor Grover, I understand, has a study coming up in the very near future. He organized a preoperative randomized trial for the Department of Veteran Affairs. Could you tell us more about this study? Thank you.
DR W. ROBIN HOWE (Paducah, KY): Do you know the percentage of your off-pump patients who did not have any aortic manipulation, and if you adjust the stroke rate for that, is it still significant? I am concerned, like Dr Arom, that we are still looking at apples and oranges and not truly comparing apples and apples.
DR CLEVELAND: I would first like to thank Dr Arom for his comments and say that they are probably apropos, as we are in Florida trying to figure out who will be the next President.
In terms of the designation of greater than 20 cases, that was an arbitrary number that we picked, and I would agree with you that as I am still gaining a lot of learning experience with this, 20 is probably too few. What we wished to include was as much volume, if you will, to have large numbers to look at for statistical purposes. We have not run the analysis, but it would be interesting to go back and see if we set the bench mark to centers that included at least 50. I know that once you start making those demands for volume, you start looking then at a few centers, and one of the things that we wanted to do with this study was make it really a composite reflection of what I think is an evolving, moving target.
In the STS database, one of the things that is interesting is when you start to examine the amount of detail provided by the database manager forms. It’s difficult to figure out the total number of bypasses done per patient. You get such detail about which arteries are used, whether it’s gastroepiploic, radial, mammary, and you get venous grafts. You can get total venous and total arterial anastomoses and try to make inferences. We don’t actually have the total number of grafts per patient, but my inference is because there are more distal venous anastomoses done, the on-pump group in this study perhaps had more complete revascularization. We could not answer one of your concerns, which is long-term graft patency. As you know, the Society of Thoracic Surgeons database is a retrospective database and we can only look at outcomes, and a prospective index such as graft patency is something that can’t be examined.
In regard to subsetting the patients out with aortic manipulation, there was no effort to look at that, and I think that is an interesting point and I agree that it could absolutely account for part of the stroke difference, but that was not done.
DR GORDON F. MURRAY (Morgantown, WV): Just a quick question, but first I would like to thank the Association for inviting me to represent the STS here at the meeting. I am representing Dr Jack Matloff, who is the President of the STS and was not able to be here. However, I would like to affirm that Jack has been working very hard all year reinvigorating and restructuring the STS to meet all the many challenges that confront our specialty. Jack is doing a great job, and I hope you will all follow what is happening in the STS with interest and with your participation.
This was an excellent presentation and certainly again attests to the power of our national cardiac database. Adequate revascularization I guess is one limb of the concern. The obverse is if you are going to do more revascularization off-pump, is there going to be an incremental morbidity? Do you have information from your data that might suggest that doing four to seven grafts is more morbd than doing one to three off-pump?
DR CLEVELAND: That is an interesting thought and I think we should go back and look at that. To kind of weave some of this into Dr Arom’s last question, which is something that Dr Grover is putting together in the VA system, we are currently in the process of applying through the cooperative studies program to have a randomized controlled trial of on- versus off-pump. The exclusion criteria are going to be very few. I think the only things we are excluding are patients with an ejection fraction less than 25%, and that is really about it. So patients will be randomized in the operating room and draw a card whether to be on-pump or off-pump. Part of the outcomes of that study are going to not only be the clinical type of outcomes we are all interested in here acutely, but we are going to recatheterize these patients prior to leaving the hospital and also at 1 year to look at both early and long-term angiographic patency, because I think there is no question that there probably is a selection bias in terms of what goes on right now in terms of approaching patients with single or double vessel disease more with an off-pump strategy. Again, groups that have a lot more familiarity with off-pump approaches have begun in the last few years to begin to do multivessel revascularization off-pump, but it’s a different operation.
So these are our plans for the randomized trial and we think this will answer some of these very important questions that have been brought up today. Unfortunately, again, with a retrospective database like the STS, we can’t answer those questions currently.
|
References |
|---|
|
TopFootnotesAbstractIntroductionMaterial and methodsResultsCommentDiscussionReferences |
|---|
This article has been cited by other articles:
|
|
 |
|
  A. L. Shroyer, F. L. Grover, B. Hattler, J. F. Collins, G. O. McDonald, E. Kozora, J. C. Lucke, J. H. Baltz, D. Novitzky, and the Veterans Affairs Randomized On/Off Bypass (ROO On-Pump versus Off-Pump Coronary-Artery Bypass Surgery N. Engl. J. Med., November 5, 2009; 361(19): 1827 - 1837. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Puskas, V. H. Thourani, P. Kilgo, W. Cooper, T. Vassiliades, J. D. Vega, C. Morris, E. Chen, B. J. Schmotzer, R. A. Guyton, et al. Off-pump coronary artery bypass disproportionately benefits high-risk patients. Ann. Thorac. Surg., October 1, 2009; 88(4): 1142 - 1147. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. A. Cooper, V. H. Thourani, R. A. Guyton, P. Kilgo, O. M. Lattouf, E. P. Chen, C. D. Morris, J. D. Vega, T. A. Vassiliades Jr, and J. D. Puskas Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting Circulation, September 15, 2009; 120(11_suppl_1): S59 - S64. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Abu-Omar and D. P. Taggart The present status of off-pump coronary artery bypass grafting Eur. J. Cardiothorac. Surg., August 1, 2009; 36(2): 312 - 321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Chu, F. G. Bakaeen, T. K. Dao, S. A. LeMaire, J. S. Coselli, and J. Huh On-Pump Versus Off-Pump Coronary Artery Bypass Grafting in a Cohort of 63,000 Patients. Ann. Thorac. Surg., June 1, 2009; 87(6): 1820 - 1827. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Nishiyama, M. Horiguchi, S. Shizuta, T. Doi, N. Ehara, R. Tanuguchi, Y. Haruna, Y. Nakagawa, Y. Furukawa, M. Fukushima, et al. Temporal Pattern of Strokes After On-Pump and Off-Pump Coronary Artery Bypass Graft Surgery. Ann. Thorac. Surg., June 1, 2009; 87(6): 1839 - 1844. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Konety, G. E. Rosenthal, and M. S. Vaughan-Sarrazin Surgical volume and outcomes of off-pump coronary artery bypass graft surgery: Does it matter? J. Thorac. Cardiovasc. Surg., May 1, 2009; 137(5): 1116 - 23.e1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D. Angelini, L. Culliford, D. K. Smith, M. C.K. Hamilton, G. J. Murphy, R. Ascione, A. Baumbach, and B. C. Reeves Effects of on- and off-pump coronary artery surgery on graft patency, survival, and health-related quality of life: long-term follow-up of 2 randomized controlled trials. J. Thorac. Cardiovasc. Surg., February 1, 2009; 137(2): 295 - 303. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. W. Klein, P. Kolm, X. Xu, R. J. Krone, H. V. Anderson, J. S. Rumsfeld, R. G. Brindis, and W. S. Weintraub A Longitudinal Assessment of Coronary Interventional Program Quality: A Report From the American College of Cardiology-National Cardiovascular Data Registry J. Am. Coll. Cardiol. Intv., February 1, 2009; 2(2): 136 - 143. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Puskas, P. D. Kilgo, O. M. Lattouf, V. H. Thourani, W. A. Cooper, T. A. Vassiliades, E. P. Chen, J. D. Vega, and R. A. Guyton Off-Pump Coronary Bypass Provides Reduced Mortality and Morbidity and Equivalent 10-Year Survival Ann. Thorac. Surg., October 1, 2008; 86(4): 1139 - 1146. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Glas, M. Swaminathan, S. T. Reeves, J. S. Shanewise, D. Rubenson, P. K. Smith, J. P. Mathew, S. K. Shernan, and Council for Intraoperative Echocardiography of the Guidelines for the Performance of a Comprehensive Intraoperative Epiaortic Ultrasonographic Examination: Recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists; Endorsed by the Society of Thoracic Surgeons Anesth. Analg., May 1, 2008; 106(5): 1376 - 1384. [Full Text] [PDF]
|
|
|
|
|
|
J. Nakano, H. Okabayashi, M. Hanyu, Y. Soga, T. Nomoto, Y. Arai, T. Matsuo, M. Kai, and M. Kawatou Risk factors for wound infection after off-pump coronary artery bypass grafting: Should bilateral internal thoracic arteries be harvested in patients with diabetes? J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 540 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Hammon Extracorporeal Circulation: The Response of Humoral and Cellular Elements of Blood to Extracorporeal Circulation Card. Surg. Adult, January 1, 2008; 3(2008): 370 - 389. [Full Text]
|
|
|
|
|
|
J. D. Puskas, F. H. Edwards, P. A. Pappas, S. O'Brien, E. D. Peterson, P. Kilgo, and T. B. Ferguson Jr Off-Pump Techniques Benefit Men and Women and Narrow the Disparity in Mortality After Coronary Bypass Grafting Ann. Thorac. Surg., November 1, 2007; 84(5): 1447 - 1456. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Puskas and M. Steele Would You Like Some Cardiopulmonary Bypass With Your Coronary Revascularization? Circulation, October 16, 2007; 116(16): 1756 - 1758. [Full Text] [PDF]
|
|
|
|
|
|
J. D. Puskas, P. D. Kilgo, M. Kutner, S. V. Pusca, O. Lattouf, and R. A. Guyton Off-Pump Techniques Disproportionately Benefit Women and Narrow the Gender Disparity in Outcomes After Coronary Artery Bypass Surgery Circulation, September 11, 2007; 116(11_suppl): I-192 - I-199. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. L. Hannan, C. Wu, C. R. Smith, R. S.D. Higgins, R. E. Carlson, A. T. Culliford, J. P. Gold, and R. H. Jones Off-Pump Versus On-Pump Coronary Artery Bypass Graft Surgery: Differences in Short-Term Outcomes and in Long-Term Mortality and Need for Subsequent Revascularization Circulation, September 4, 2007; 116(10): 1145 - 1152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Paparella, G. Cappabianca, P. Malvindi, A. Paramythiotis, A. Galeone, N. Veneziani, C. Fondacone, and L. de Luca Tupputi Schinosa Myocardial injury after off-pump coronary artery bypass grafting operation Eur. J. Cardiothorac. Surg., September 1, 2007; 32(3): 481 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Sedrakyan Response to Letter by Tourmousoglou et al Stroke, September 1, 2007; 38(9): e84 - e85. [Full Text] [PDF]
|
|
|
|
 |
|
 D. van Dijk, M. Spoor, R. Hijman, H. M. Nathoe, C. Borst, E. W. L. Jansen, D. E. Grobbee, P. P. T. de Jaegere, C. J. Kalkman, and for the Octopus Study Group Cognitive and Cardiac Outcomes 5 Years After Off-Pump vs On-Pump Coronary Artery Bypass Graft Surgery JAMA, February 21, 2007; 297(7): 701 - 708. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Allen, W. T. McBride, T. J. McMurray, A. S. Phillips, S. P. Penugonda, G. Campalani, I. S. Young, and M. A. Armstrong Cell Salvage Alters the Systemic Inflammatory Response After Off-Pump Coronary Artery Bypass Grafting Surgery Ann. Thorac. Surg., February 1, 2007; 83(2): 578 - 585. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. DeSimone and P. Sergeant Off-pump myocardial revascularization MMCTS, October 9, 2006; 2006(1009): 539. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. J. Ferreira-Gonzalez, A. Ribera, P. Cascant, G. Permanyer-Miralda, and for the ARCA study group Outcomes in off-pump vs. on-pump coronary artery bypass grafting stratified by pre-operative risk profile: an assessment using propensity score Eur. Heart J., October 2, 2006; 27(20): 2473 - 2480. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ben Ari, E. Elinav, A. Elami, and I. Matot Off-pump coronary artery bypass grafting in a patient with Child class C liver cirrhosis awaiting liver transplantation Br. J. Anaesth., October 1, 2006; 97(4): 468 - 472. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Mishra, R. Malhotra, A. Karlekar, Y. Mishra, and N. Trehan Propensity Case-Matched Analysis of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting in Patients With Atheromatous Aorta Ann. Thorac. Surg., August 1, 2006; 82(2): 608 - 614. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. E. Lehmann, S. Schroeder, W. Hartmann, O. Dewald, M. Book, S. U. Weber, J.-C. Schewe, and F. Stuber A single nucleotide polymorphism of macrophage migration inhibitory factor is related to inflammatory response in coronary bypass surgery using cardiopulmonary bypass. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 59 - 63. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Abu-Omar and C. Ratnatunga Cardiopulmonary Bypass and Renal Injury Perfusion, July 1, 2006; 21(4): 209 - 213. [Abstract] [PDF]
|
|
|
|
|
|
B. C. Reeves, R. Ascione, M. Caputo, and G. D. Angelini Morbidity and mortality following acute conversion from off-pump to on-pump coronary surgery. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 941 - 947. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Goldman, F. P. Sutter, M. A. C. Wertan, F. D. Ferdinand, C. L. Trace, and L. E. Samuels Outcome improvement and cost reduction in an increasingly morbid cardiac surgery population. Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2006; 10(2): 171 - 175. [Abstract] [PDF]
|
|
|
|
 |
|
 D. A Hett Anaesthesia for off-pump coronary artery surgery CEACCP, April 1, 2006; 6(2): 60 - 62. [Full Text] [PDF]
|
|
|
|
 |
|
 E Sharoni, H K Song, R J Peterson, R A Guyton, and J D Puskas Off pump coronary artery bypass surgery for significant left ventricular dysfunction: safety, feasibility, and trends in methodology over time--an early experience Heart, April 1, 2006; 92(4): 499 - 502. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Halkos, W. A. Cooper, R. Petersen, J. D. Puskas, O. M. Lattouf, J. M. Craver, and R. A. Guyton Early Administration of Clopidogrel Is Safe After Off-Pump Coronary Artery Bypass Surgery Ann. Thorac. Surg., March 1, 2006; 81(3): 815 - 819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Brown, R. S. Poston, J. S. Gammie, M. G. Cardarelli, K. Schwartz, J. A. H. Sikora, S. Yi, R. N. Pierson III, and B. P. Griffith Off-Pump Versus On-Pump Coronary Artery Bypass Grafting in Consecutive Patients: Decision-Making Algorithm and Outcomes Ann. Thorac. Surg., February 1, 2006; 81(2): 555 - 561. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Paparella, A. Galeone, M. T. Venneri, M. Coviello, G. Scrascia, N. Marraudino, M. Quaranta, L. de Luca Tupputi Schinosa, and S. J. Brister Activation of the coagulation system during coronary artery bypass grafting: Comparison between on-pump and off-pump techniques J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 290 - 297. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Buffolo, J. N. R. Branco, L. R. Gerola, L. F. Aguiar, C. A. Teles, J. H. Palma, and R. Catani Off-Pump Myocardial Revascularization: Critical Analysis of 23 Years' Experience in 3,866 Patients Ann. Thorac. Surg., January 1, 2006; 81(1): 85 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Jin, L. F. Hiratzka, G. L. Grunkemeier, A. Krause, and U. S. Page III Aborted Off-Pump Coronary Artery Bypass Patients Have Much Worse Outcomes Than On-Pump or Successful Off-Pump Patients Circulation, August 30, 2005; 112(9_suppl): I-332 - I-337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Kobayashi, T. Tashiro, M. Ochi, H. Yaku, G. Watanabe, T. Satoh, O. Tagusari, H. Nakajima, S. Kitamura, and for the Japanese Off-Pump Coronary Revascularizati Early Outcome of a Randomized Comparison of Off-Pump and On-Pump Multiple Arterial Coronary Revascularization Circulation, August 30, 2005; 112(9_suppl): I-338 - I-343. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Williams, L. H. Muhlbaier, J. N. Schroder, J. A. Hata, E. D. Peterson, P. K. Smith, K. P. Landolfo, R. H. Messier, R. D. Davis, and C. A. Milano Risk-Adjusted Short- and Long-Term Outcomes for On-Pump Versus Off-Pump Coronary Artery Bypass Surgery Circulation, August 30, 2005; 112(9_suppl): I-366 - I-370. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Calafiore, G. Di Giammarco, G. Teodori, A. L. Iaco, M. Pano, M. Contini, G. Vitolla, and M. Di Mauro Bilateral internal thoracic artery grafting with and without cardiopulmonary bypass: Six-year clinical outcome J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 340 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. G. Glance, A. W. Dick, T. M. Osler, and D. B. Mukamel The Relation Between Surgeon Volume and Outcome Following Off-Pump vs On-Pump Coronary Artery Bypass Graft Surgery Chest, August 1, 2005; 128(2): 829 - 837. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Caus, Y. Seree, P. Marin, M. Khairi, A. Bakkali, J. C. Guillen, J. L. Bonnet, and D. Metras Off-pump coronary surgery in selected patients: better early outcome but more recurrence of angina? Interactive CardioVascular and Thoracic Surgery, August 1, 2005; 4(4): 322 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Karthik, A. K. Srinivasan, A. D. Grayson, T. Friede, and B. M. Fabri Effect of the Left Internal Mammary Artery to the Left Anterior Descending Artery on Mortality and Morbidity After Combined Coronary and Valve Operations Ann. Thorac. Surg., July 1, 2005; 80(1): 163 - 169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Wippermann, J. M. Albes, M. Hartrumpf, M. Kaluza, R. Vollandt, R. Bruhin, and T. Wahlers Comparison of minimally invasive closed circuit extracorporeal circulation with conventional cardiopulmonary bypass and with off-pump technique in CABG patients: selected parameters of coagulation and inflammatory system Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 127 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D.L. Keenan, Y. Abu-Omar, and D. P. Taggart Bypassing the Pump: Changing Practices in Coronary Artery Surgery Chest, July 1, 2005; 128(1): 363 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Baumgartner, S. Burrows, P. J. del Nido, T. J. Gardner, S. Goldberg, R. C. Gorman, G. V. Letsou, A. Mascette, R. E. Michler, J. D. Puskas, et al. Recommendations of the National Heart, Lung, and Blood Institute Working Group on Future Direction in Cardiac Surgery Circulation, June 7, 2005; 111(22): 3007 - 3013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Abu-Omar, S. Mussa, M. J. Naik, N. MacCarthy, S. Standing, and D. P. Taggart Evaluation of Cystatin C as a marker of renal injury following on-pump and off-pump coronary surgery Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 893 - 898. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Bainbridge, J. Martin, and D. Cheng Off Pump Coronary Artery Bypass Graft Surgery Versus Conventional Coronary Artery Bypass Graft Surgery: A Systematic Review of the Literature Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2005; 9(1): 105 - 111. [Abstract] [PDF]
|
|
|
|
|
|
J.-F. Legare, K. J. Buth, and G. M. Hirsch Conversion to on pump from OPCAB is associated with increased mortality: results from a randomized controlled trial Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 296 - 301. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Pepper Controversies in Off-pump Coronary Artery Surgery Clin. Med. Res., February 1, 2005; 3(1): 27 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pandey, A. D. Grayson, D. M. Pullan, B. M. Fabri, and W. C. Dihmis Total arterial revascularisation: effect of avoiding cardiopulmonary bypass on in-hospital mortality and morbidity in a propensity-matched cohort Eur. J. Cardiothorac. Surg., January 1, 2005; 27(1): 94 - 98. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. A Black, S. Ghosh, K. Sin, T. Spyt, and R. Pillai Off-Pump Coronary Artery Bypass Surgery Asian Cardiovasc Thorac Ann, December 1, 2004; 12(4): 379 - 386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Hravnak, L. A. Hoffman, M. I. Saul, T. G. Zullo, J. F. Cuneo, and R. V. Pellegrini Short-Term Complications and Resource Utilization in Matched Subjects After On-Pump or Off-Pump Primary Isolated Coronary Artery Bypass Am. J. Crit. Care., November 1, 2004; 13(6): 499 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. C. Patel, N. U. Patel, D. F. Loulmet, J. C. McCabe, and V. A. Subramanian Emergency conversion to cardiopulmonary bypass during attempted off-pump revascularization results in increased morbidity and mortality J. Thorac. Cardiovasc. Surg., November 1, 2004; 128(5): 655 - 661. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Mariani, A. D'Alfonso, and J. G. Grandjean Total Arterial Off-Pump Coronary Surgery: Time to Change Our Habits? Ann. Thorac. Surg., November 1, 2004; 78(5): 1591 - 1597. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Shahian, E. H. Blackstone, F. H. Edwards, F. L. Grover, G. L. Grunkemeier, D. C. Naftel, S. A.M. Nashef, W. C. Nugent, and E. D. Peterson Cardiac Surgery Risk Models: A Position Article Ann. Thorac. Surg., November 1, 2004; 78(5): 1868 - 1877. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Saxena and R. K. W. Tam Combined off-pump coronary artery bypass surgery and pulmonary resection Ann. Thorac. Surg., August 1, 2004; 78(2): 498 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G J Murphy and G D Angelini Coronary artery bypass grafting on the beating heart: changing the paradigm J R Soc Med, July 1, 2004; 97(7): 313 - 316. [Full Text] [PDF]
|
|
|
|
|
|
J. Grunenfelder, M. Umbehr, A. Plass, L. Bestmann, F. E. Maly, G. Zund, and M. Turina Genetic polymorphisms of apolipoprotein E4 and tumor necrosis factor {beta} as predisposing factors for increased inflammatory cytokines after cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., July 1, 2004; 128(1): 92 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Karthik, A. K. Srinivasan, A. D. Grayson, M. Jackson, and N. K. Mediratta Left internal mammary artery to the left anterior descending artery: effect on morbidity and mortality and reasons for nonusage Ann. Thorac. Surg., July 1, 2004; 78(1): 142 - 148. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Yokoyama, S. Takase, Y. Misawa, K. Takahashi, Y. Sato, and H. Satokawa A simple technique of introducing intracoronary shunts for off-pump coronary artery bypass surgery Ann. Thorac. Surg., July 1, 2004; 78(1): 352 - 354. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G Raja and G. D Dreyfus Will off-pump coronary artery surgery replace conventional coronary artery surgery? J R Soc Med, June 1, 2004; 97(6): 275 - 278. [Full Text] [PDF]
|
|
|
|
|
|
T. Suzuki, M. Okabe, M. Handa, F. Yasuda, and Y. Miyake Usefulness of preoperative intraaortic balloon pump therapy during off-pump coronary artery bypass grafting in high-risk patients Ann. Thorac. Surg., June 1, 2004; 77(6): 2056 - 2059. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Sergeant, P. Wouters, B. Meyns, C. Bert, J. Van Hemelrijck, C. Bogaerts, G. Sergeant, and K. Slabbaert OPCAB versus early mortality and morbidity: an issue between clinical relevance and statistical significance Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 779 - 785. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Puskas, W. H. Williams, E. M. Mahoney, P. R. Huber, P. C. Block, P. G. Duke, J. R. Staples, K. E. Glas, J. J. Marshall, M. E. Leimbach, et al. Off-Pump vs Conventional Coronary Artery Bypass Grafting: Early and 1-Year Graft Patency, Cost, and Quality-of-Life Outcomes: A Randomized Trial JAMA, April 21, 2004; 291(15): 1841 - 1849. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Parolari, P. Biglioli, F. Alamanni, M. J. Magee, L. P. Coombs, E. D. Peterson, and M. J. Mack Improved Early Outcomes After OPCAB: When Will the Final Answer Come? * Response Circulation, April 13, 2004; 109(14): e181 - e181. [Full Text] [PDF]
|
|
|
|
|
|
S. Verma, P. W.M. Fedak, R. D. Weisel, P. E. Szmitko, M. V. Badiwala, D. Bonneau, D. Latter, L. Errett, and Y. LeClerc Off-Pump Coronary Artery Bypass Surgery: Fundamentals for the Clinical Cardiologist Circulation, March 16, 2004; 109(10): 1206 - 1211. [Full Text] [PDF]
|
|
|
|
|
|
Z. Straka, P. Widimsky, K. Jirasek, P. Stros, J. Votava, T. Vanek, P. Brucek, M. Kolesar, and R. Spacek Off-pump versus on-pump coronary surgery: final results from a prospective randomized study Prague-4 Ann. Thorac. Surg., March 1, 2004; 77(3): 789 - 793. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. W. Lytle and J. F. Sabik On-Pump and Off-Pump Bypass Surgery: Tools for Revascularization Circulation, February 24, 2004; 109(7): 810 - 812. [Full Text] [PDF]
|
|
|
|
|
|
J.-F. Legare, K. J. Buth, S. King, J. Wood, J. A. Sullivan, C. H. Friesen, J. Lee, K. Stewart, and G. M. Hirsch Coronary Bypass Surgery Performed off Pump Does Not Result in Lower In-Hospital Morbidity Than Coronary Artery Bypass Grafting Performed on Pump Circulation, February 24, 2004; 109(7): 887 - 892. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Racz, E. L. Hannan, O. W. Isom, V. A. Subramanian, R. H. Jones, J. P. Gold, T. J. Ryan, A. Hartman, A. T. Culliford, E. Bennett, et al. A comparison of short- and long-term outcomes after off-pump and on-pump coronary artery bypass graft surgery with sternotomy J. Am. Coll. Cardiol., February 18, 2004; 43(4): 557 - 564. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Athanasiou, S. Al-Ruzzeh, P. Kumar, M.-C. Crossman, M. Amrani, J. R. Pepper, R. Del Stanbridge, R. Casula, and B. Glenville Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients Ann. Thorac. Surg., February 1, 2004; 77(2): 745 - 753. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Taggart Off-pump surgery and cerebral injury J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 7 - 9. [Full Text] [PDF]
|
|
|
|
|
|
J. F. Sabik, E. H. Blackstone, B. W. Lytle, P. L. Houghtaling, A. M. Gillinov, and D. M. Cosgrove Equivalent midterm outcomes after off-pump and on-pump coronary surgery J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 142 - 148. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Wu, G. L. Grunkemeier, and J. R. Handy Jr Coronary artery bypass grafting: Are risk models developed from on-pump surgery valid for off-pump surgery? J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 174 - 178. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Piacentino III, J. Jones, C. A. Fisher, A. K. Singhal, M. Macha, J. B. McClurken, and S. Furukawa Off-pump technique for insertion of a HeartMate vented electric left ventricular assist device J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 262 - 264. [Full Text] [PDF]
|
|
|
|
|
|
S. Al-Ruzzeh, T. Athanasiou, S. George, and M. Amrani Methodological approach in adopting off-pump coronary artery bypass surgery in a British cardiothoracic unit: Harefield experience Perfusion, January 1, 2004; 19(1_suppl): S61 - S66. [Abstract] [PDF]
|
|
|
|
|
|
H. K. Song, R. J. Petersen, E. Sharoni, R. A. Guyton, and J. D. Puskas Safe evolution towards routine off-pump coronary artery bypass: negotiating the learning curve Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 947 - 952. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Boening, C. Friedrich, J. Hedderich, J. Schoettler, S. Fraund, and J. T. Cremer Early and medium-term results after on-pump and off-pump coronary artery surgery: a propensity score analysis Ann. Thorac. Surg., December 1, 2003; 76(6): 2000 - 2006. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Suzuki, M. Okabe, F. Yasuda, Y. Miyake, M. Handa, and T. Nakamura Our experiences for off-pump coronary artery bypass grafting to the circumflex system Ann. Thorac. Surg., December 1, 2003; 76(6): 2013 - 2016. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Michalopoulos, S. Geroulanos, and S. D. Mentzelopoulos Determinants of Candidemia and Candidemia-Related Death in Cardiothoracic ICU Patients Chest, December 1, 2003; 124(6): 2244 - 2255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Reston, S. J. Tregear, and C. M. Turkelson Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting Ann. Thorac. Surg., November 1, 2003; 76(5): 1510 - 1515. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Talpahewa, R. Ascione, G. D. Angelini, and A. T. Lovell Cerebral cortical oxygenation changes during OPCAB surgery Ann. Thorac. Surg., November 1, 2003; 76(5): 1516 - 1522. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. V. Arom and F. L. Grover Adult cardiac surgery during the first 50 years of the Southern Thoracic Surgical Association Ann. Thorac. Surg., November 1, 2003; 76(90050): S17 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D'Ancona, J. I. S. de Ibarra, R. Baillot, P. Mathieu, D. Doyle, J. Metras, D. Desaulniers, and F. Dagenais Determinants of stroke after coronary artery bypass grafting Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 552 - 556. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Ngaage Off-pump coronary artery bypass grafting: the myth, the logic and the science Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 557 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Al-Ruzzeh, G. Ambler, G. Asimakopoulos, R. Z. Omar, R. Hasan, B. Fabri, A. El-Gamel, A. DeSouza, V. Zamvar, S. Griffin, et al. Off-Pump Coronary Artery Bypass (OPCAB) Surgery Reduces Risk-Stratified Morbidity and Mortality: A United Kingdom Multi-Center Comparative Analysis of Early Clinical Outcome Circulation, September 9, 2003; 108(90101): II-1 - 8. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Novick, S. A. Fox, B. B. Kiaii, L. W. Stitt, R. Rayman, K. Kodera, A. H. Menkis, and W. D. Boyd Analysis of the learning curve in telerobotic, beating heart coronary artery bypass grafting: a 90 patient experience Ann. Thorac. Surg., September 1, 2003; 76(3): 749 - 753. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Gunn and D P Taggart Revascularisation for acute coronary syndromes: PCI or CABG? Heart, September 1, 2003; 89(9): 967 - 970. [Full Text] [PDF]
|
|
|
|
|
|
R. J. Dabal, J. R. Goss, C. Maynard, and G. S. Aldea The effect of left internal mammary artery utilization on short-term outcomes after coronary revascularization Ann. Thorac. Surg., August 1, 2003; 76(2): 464 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Biglioli, A. Cannata, F. Alamanni, M. Naliato, M. Porqueddu, M. Zanobini, E. Tremoli, and A. Parolari Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 260 - 269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. B. Beauford, D. J. Goldstein, F. F. Sardari, R. Karanam, B. Luk, T. W. Prendergast, P. G. Burns, P. Garland, C. Chen, O. Patafio, et al. Multivessel off-pump revascularization in octogenarians: early and midterm outcomes Ann. Thorac. Surg., July 1, 2003; 76(1): 12 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. F. Immer, P. A. Berdat, A. S. Immer-Bansi, F. S. Eckstein, S. Muller, H. Saner, and T. P. Carrel Benefit to quality of life after Off-Pump versus On-Pump coronary bypass surgery Ann. Thorac. Surg., July 1, 2003; 76(1): 27 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. W. Donias, R. Pande, H. L. Karamanoukian, M. Gomberg-Maitland, J. L. Halperin, J. Healey, E. Fenwick, B. O'Brien, H. M. Nathoe, E. Buskens, et al. Off-Pump Coronary Bypass Surgery N. Engl. J. Med., May 8, 2003; 348(19): 1928 - 1931. [Full Text] [PDF]
|
|
|
|
|
|
R. Ascione and G. D. Angelini Off-pump coronary artery bypass surgery: The implications of the evidence J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 779 - 781. [Full Text] [PDF]
|
|
|
|
|
|
J. D. Puskas, W. H. Williams, P. G. Duke, J. R. Staples, K. E. Glas, J. J. Marshall, M. Leimbach, P. Huber, S. Garas, B. H. Sammons, et al. Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: A prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 797 - 808. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Schroeder, N. Borger, H. Wrigge, A. Welz, C. Putensen, A. Hoeft, and F. Stuber A tumor necrosis factor gene polymorphism influences the inflammatory response after cardiac operation Ann. Thorac. Surg., February 1, 2003; 75(2): 534 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Piacentino III, A. K. Singhal, M. Macha, J. B. McClurken, C. A. Fisher, and S. Furukawa Off-pump technique for Thoratec left ventricular assist device insertion Ann. Thorac. Surg., February 1, 2003; 75(2): 607 - 609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. M. Nathoe, D. van Dijk, E. W.L. Jansen, W. J.L. Suyker, J. C. Diephuis, W.-J. van Boven, A. B. de la Riviere, C. Borst, C. J. Kalkman, D. E. Grobbee, et al. A Comparison of On-Pump and Off-Pump Coronary Bypass Surgery in Low-Risk Patients N. Engl. J. Med., January 30, 2003; 348(5): 394 - 402. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
