Selective use of off-pump coronary bypass surgery reduces mortality and neurologic morbidity associated with high-risk coronary bypass surgery: A 400-case comparative experience

Heart Surgery Forum

Volumn 7, Issue 6, 2004, Pages 451-457

  Gold, Jeffrey P ^a,b   Wasnick, John ^a   Maldarelli, William ^a   Zhuraavlev, Ilya ^a   Torres, Kaila Enitt ^a   Condit, Douglas ^a  

^a ALBERT EINSTEIN COLLEGE OF MEDICINE   (United States)

^b MONTEFIORE MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; FIBRINOGEN RECEPTOR ANTAGONIST; HEPARIN; PHENYLEPHRINE; WARFARIN;

ADULT; AGED; ARTICLE; COMPUTER ASSISTED TOMOGRAPHY; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; CORONARY ARTERY DISEASE; FEMALE; HIGH RISK POPULATION; HUMAN; INTERMETHOD COMPARISON; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MORBIDITY; MULTIPLE ORGAN FAILURE; OFF PUMP CORONARY SURGERY; PRIORITY JOURNAL; RISK ASSESSMENT; STATISTICAL ANALYSIS; STATISTICAL SIGNIFICANCE; STROKE; SURGICAL MORTALITY; THROMBOSIS; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; UNITED STATES; COMORBIDITY; COMPARATIVE STUDY; INCIDENCE; METHODOLOGY; MIDDLE AGED; MORTALITY; NEUROLOGIC DISEASE; RETROSPECTIVE STUDY; RISK FACTOR;

AGED; COMORBIDITY; CORONARY ARTERY BYPASS, OFF-PUMP; FEMALE; HUMANS; INCIDENCE; MALE; MIDDLE AGED; NERVOUS SYSTEM DISEASES; NEW YORK; RETROSPECTIVE STUDIES; RISK ASSESSMENT; RISK FACTORS;

EID: 12844278120     PISSN: 10983511     EISSN: None     Source Type: Journal    
DOI: 10.1532/HSF98.20041112     Document Type: Article

References (54)

1. Amarenco P. 1996. Atherosclerotic disease of the aortic arch as a risk factor for recurrent ischemic stroke. N Engl J Med 334:1216-21.
2. Angelini GD, Taylor FC, Reeves BC, Ascione R. 2002. Early and midterm outcome after off-pump and on-pump surgery in beating heart against cardioplegic arrest studies (BHACAS 1 and 2): a pooled analysis of two randomised controlled trials. Lancet 359:1194-9.
3. Barbut D, Gold JP. 1996. Aortic atheromatosis and risks of cerebral embolization. J Cardiothorac Vasc Anesth 10:24-9.
4. Barbut D, Hinton RB, Szatrowski TP, et al. 1994. Cerebral emboli detected during bypass surgery are associated with clamp removal. Stroke 25:2398-402.
5. Barbut D, Lo YW, Gold JP et al. 1997. Impact of embolization during coronary artery bypass grafting on outcome and length of stay. Ann Thorac Surg 63:998-1002.
6. BhaskerRao B, VanHimbergen D, Edmonds HL Jr, et al. 1998. Evidence for improved cerebral function after minimally invasive bypass surgery. J Card Surg 13:27-31.
7. Blauth CI, Schulenberg WE, Taylor KM. 1988. Cerebral microembolism during cardiopulmonary bypass: retinal microvascular studies in-vivo with fluorescent angiography. J Thorac Cardiovasc Surg 95:668-76.
8. Block PC, Peterson ED, Krone R, et al. 1999. Identification of variables needed to risk adjust outcomes of coronary interventions: evidence-based guidelines for efficient data collection. J Am Coll Cardiol 34:613.
9. Bowles BJ, Lee JD, Dang CR, et al. 2001. Coronary artery bypass performed without the use of cardiopulmonary bypass is associated with reduced cerebral microemboli and improved clinical results. Chest 119:25-30.
10. Brækken SK, Russell D, Brucher R, Abdelnoor M, Svennevig JL. 1997. Cerebral microembolic signals during cardiopulmonary bypass surgery: frequency, time of occurrence, and association with patient and surgical characteristics. Stroke 28:1988-92.
11. Cernaianu AC, Vassilidze TV, Flum DR, et al. 1995. Predictors of stroke after cardiac surgery. J Card Surg 4:334-9.
12. Charlesworth DC, Likosky DS, Martin CA, et al, and the Northern New England Cardiovascular Disease Study Group. 2003. Development and validation of a prediction model for strokes after coronary artery bypass grafting. Ann Thorac Surg 76:436-43.
13. Clark RE, Brillman J, Davis DA, et al. 1995. Microemboli during coronary artery bypass grafting: genesis and effect on outcome. J Thorac Cardiovasc Surg 109:249-58.
14. Clark RE, Brillman J, Davis DA, Lovell MR, Price TRP, Magovern GJ. 1995. Microemboli during coronary artery bypass grafting: genesis and effect on outcome. J Thorac Cardiovasc Surg 109:249-58.
15. D'Ancona G, Saez de Ibarra JI, Baillot R, et al. 2003. Determinants of stroke after coronary artery bypass grafting. Eur J Cardiothorac Surg 24:552-6.
16. Davila-Roman VG, Phillips KJ, Daily NN, et al. 1996. Intraoperative transesophageal echocardiography and epiaortic ultrasound for assessment for atherosclerosis of the thoracic aorta. J Am Coll Cardiol 28:942-7.
17. Diegeler A, Hirsch R, Schneider F, et al. 2000. Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation. Ann Thorac Surg 69:1162-6.
18. Gold JP, Charlson ME, Williams-Russo TP, et al. 1995. Improvement of outcomes after coronary artery bypass: a randomized trial comparing intraoperative high versus low mean arterial pressure. J Thorac Cardiovasc Surg 110:1302-11.
19. Hangler HB, Nagele G, Danzmayr M, et al. 2003. Modification of surgical technique for ascending aortic atherosclerosis: impact on stroke reduction in coronary artery bypass grafting. J Thorac Cardiovasc Surg 126:391-400.
20. Hartman GS, Peterson J, Konstadt SN, et al. 1996. High reproducibility in the interpretation of intraoperative transesophageal echocardiographic evaluation of aortic atheromatous disease. Anesth Analg 1996;82:539-43.
21. Jones RH, Hannan EL, Hammermeister KE, et al. 1998. Identification of preoperative variables needed for risk adjustment of short-term mortality after coronary artery bypass graft surgery: the Working Group Panel on the Cooperative CABG Database Project. J Am Coll Cardiol 31:1214-5.
22. Kadoi Y, Fujita N. 2003. Increasing mean arterial pressure improves jugular venous oxygen saturation in patients with and without preexisting stroke during normothermic cardiopulmonary bypass. J Clin Anesth 15:339-44.
23. Kahn NE, De Souza A, Mister R. 2004. A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery. N Engl J Med 350:21-8.
24. Konstadt SN, Reich DL, Kahn R, Viggiani RF. 1995. Transesophageal echocardiography can be used to screen for ascending aortic atherosclerosis. Anesth Analg 81:225-8.
25. Likosky DS, Leavitt BJ, Marrin CA, et al, and the Northern New England Cardiovascular Disease Study Group. 2003. Intra- and postoperative predictors of stroke after coronary artery bypass grafting. Ann Thorac Surg 76:428-34.
26. Lund C, Hol PK, Lundblad R, et al. 2003. Comparison of cerebral embolization during off-pump and on-pump coronary artery bypass surgery. Ann Thorac Surg 76:765-70.
27. Magee MJ, Coombs LP, Peterson ED, Mack MJ. 2003. Patient selection and current practice strategy for off-pump coronary artery bypass surgery. Circulation 108:II-9-14.
28. Marschall K, Kanchuger M, Kessler K, et al. 1994. Superiority of transesophageal echocardiography in detecting aortic arch atheromatous disease: identification of patients at increased risk of stroke during cardiac surgery. J Cardiothorac Vasc Anesth 1:5-13.
29. McLean RF, Wong BI, Naylor CD, et al. 1994. Cardiopulmonary bypass, temperature and central nervous system dysfunction. Circulation 90:II-250-5.
30. Mitka M. 2004. Beat goes on in "off-pump" bypass surgery: surgeon experience may be key to best outcome. JAMA 291:1821-2.
31. Moody DM, Bell MA, Challa VR, et al. 1990. Brain microemboli during cardiac surgery or aortography. Ann Neurol 4:477-86.
32. Murkin JM, Martzke JS, Buchan AM, et al. 1995. A randomized study of the influence of perfusion techniques and pH management strategy in 316 patients undergoing coronary artery bypass surgery, II: neurologic and cognitive outcomes. J Thorac Cardiovasc Surg 110:349-62.
33. Murphy PM. 1997. Pro: intraoperative transesophageal echocardiography is a cost effective strategy for cardiac surgical procedures. J Cardiothorac Vasc Anesth 2:246-9.
34. Naylor R, Cuffe RL, Rothwell PM, Loftus IM, Bell PR. 2003. A systematic review of outcome following synchronous carotid endarterectomy and coronary artery bypass: influence of surgical and patient variables. Eur J Vasc Endovasc Surg 26:230-41.
35. [NYS DOH] New York State Department of Health. 2002. Coronary artery bypass surgery in New York State 1997-1999; September 2002. Available at: http://www.health.state.ny.us/nysdoh/heart/ 1997-99_cabg.pdf. Accessed September 22, 2004.
36. [NYS DOH] New York State Department of Health. 2004. Coronary artery bypass surgery in New York State 1998-2000; February 2004. Available at: http:www.health.state.ny.us/nysdoh/heart/pdf/ 1998-2000_cabg.pdf. Accessed September 22, 2004.
37. Newman MF, Wolman R, Kanchuger M, et al. 1996. Multicenter preoperative stroke risk index for patients undergoing coronary artery bypass graft surgery: Multicenter Study of Perioperative Ischemia (McSPI) Research Group. Circulation 94(suppl 9):1174-80.
38. Nicolosi AC, Aggarwal A, Almassi GH, Olinger GN. 1996. Intraoperative epiaortic ultrasound during cardiac surgery. J Card Surg 11:49-55.
39. Peterson ED, Mark DB. 2004. Off-pump bypass surgery: ready for the big dance? JAMA 291:1897-9.
40. Plestis KA, Gold JP. 2001. Importance of blood pressure regulation in maintaining adequate tissue perfusion during cardiopulmonary bypass. Semin Thorac Cardiovasc Surg 13:170-5.
41. Puskas JD, Williams WH, Mahoney EM, et al. 2004. Off-pump vs conventional coronary artery bypass grafting: early and 1-year graft patency, cost, and quality-of-life outcomes. JAMA 291:1841-9.
42. Rao V, Christakis GT, Weisel RD, et al. 1995. Risk factors for stroke following coronary bypass surgery. J Card Surg 10:468-74.
43. Roach G, Kanchuger M, Mora Mangano C, et al. 1996. Adverse cerebral outcomes after coronary bypass surgery. N Engl J Med 335:1857-63.
44. Rorick MB, Furan AJ. 1990. Risk of cardiac surgery in patients with prior stroke. Neurology 40:835-7.
45. Saimanen EI. 2000. Perioperative stroke with coronary artery bypass surgery: analysis of risk factors. Scand Cardiovasc J 34:41-5.
46. Sharony R, Bizekis CS, Kanchuger M, et al. 2003. Off-pump coronary artery bypass grafting reduces mortality and stroke in patients with atheromatous aortas: a case control study. Circulation 108:II-15-20.
47. Sylivris S, Levi C, Matalanis G, et al. 1998. Pattern and significance of cerebral microemboli during coronary bypass grafting. Ann Thorac Surg 66:1674-8.
48. Taggart DP, Browne SM, Halligan PW, Wade DT. 1999. Is cardiopulmonary bypass still the cause of cognitive dysfunction after cardiac operations? J Thorac Cardiovasc Surg 118:414-21.
49. Taylor KM. 1994. Brain damage during cardiopulmonary bypass. Ann Thorac Surg 42:212-7.
50. Trehan N, Mishra M, Dhole S, et al. 1997. Significantly reduced incidence of stroke during coronary artery bypass grafting using transesophageal echocardiography. Eur J Cardiothorac Surg 2:234-42.
51. van der Linden J, Hadjinikolaou L, Bergman P, Lindblom D. 2001. Post-operative stroke in cardiac surgery is related to the location and extent of atherosclerotic disease in the ascending aorta. J Am Coll Cardiol 38:131-5.
52. van Dijk D, Nierich AP, Jansen EWL, et al. 2001. Early outcome after off-pump versus on-pump coronary bypass surgery. Circulation 104:1761-6.
53. Watters MPR, Cohen AM, Monk CR, Angelini GD, Ryder IG. 2000. Reduced cerebral embolic signals in beating heart coronary surgery detected by transcranial Doppler ultrasound. Br J Anaesth 84:629-31.
54. Widimsky P, Stros P, Straka Z, Jirasek K. 2004. One-year coronary bypass graft patency: a randomized comparison between off-pump and on-pump surgery: angiographic results of the Prague-4 trial. In: American College of Cardiology Annual Scientific Sessions: Late-Breaking Clinical Trials; 2004 Mar 7; New Orleans, La, USA.