Warning: mysqli_query(): (HY000/1030): Got error 28 from storage engine in /home/heart/public_html/wp-includes/wp-db.php on line 2007
Cardiovascular Controversies #2: Coronary Bypass Operations

Cardiovascular Controversies #2: On-Pump vs. Off-Pump Coronary Bypass Operations

 

On-Pump vs. Off-Pump Coronary Bypass Operations

Coronary bypass operationOn-Pump” Surgery –

  • Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body. The CPB pump itself is often referred to as a “heart–lung” machine.
  • The first successful open heart procedure on a human utilizing the heart lung machine was performed by John Gibbon on May 6, 1953 at Thomas Jefferson University Hospital in Philadelphia. Since then coronary artery bypass with the CPB machine has become routine and has indeed become one of the most commonly performed surgical procedures in America.
  • 80% of all coronary bypass operations are performed using the CPB machine and advocates of this technique point to several advantages that have been borne out in randomized, controlled studies, including:
    • More complete revascularization – Better chance of bypassing all of the diseased vessels at one time
    • Prolonged graft patency – Better chance that the bypasses will stay open and useful for a long time
    • Lower mortality rate at 1 year 

 

“Off-Pump” Surgery –

  • In the last decade, off-pump coronary artery bypass surgery was developed partly to avoid the complications of cardiopulmonary bypass during cardiac surgery. Some surgeons in the medical community believed cardiopulmonary bypass caused a post-operative cognitive decline known as postperfusion syndrome (informally called “pumphead”).
  • While the learning curve for learning how to perform off-pump coronary bypass surgery is steep, surgeons who perform this surgery frequently have been sown to be able to achieve similar results to those performing on-pump surgery.

 

Recent Duke University Research Study Published in the New England Journal of Medicine

  • Off-Pump surgery associated with increased risk of:
    • death within the first year after surgery
    • need for repeat revascularization
    • incomplete revascularization
    • early graft closure
    • risk of having another heart attack
  • There was no difference in:
    • Length of ICU or hospital stay
    • Requirement of blood transfusion
    • Time on ventillator
    • Return to the hospital for re-admission

While the off-pump approach may still have a particularly important role in selected patients at high risk for neurologic events and those with diseased ascending aortas, based on these results, any patient who is a reasonable candidate for on-pump bypass, even if the option for off-pump exists, should undergo on-pump surgery.

Enhanced by Zemanta

Comments

  1. Your comment is awaiting moderation.

    Nicely put. Thanks.

    combining viagra and levitra is viagra a prescription drug wikipedia
    viagra pills
    free trial viagra levitra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  2. Your comment is awaiting moderation.

    You actually mentioned that superbly.

    discount viagra where to purchase viagra
    generic viagra online
    tolerance for viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  3. Your comment is awaiting moderation.

    Many thanks! Useful information!

    viagra video commercial using viagra after a stroke tia
    viagra 100mg
    driving on viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  4. Your comment is awaiting moderation.

    You definitely made your point!

    teen boys taking viagra viagra erections larger
    generic viagra 100mg
    how does dilitiazem interact with viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  5. Your comment is awaiting moderation.

    Thank you! Numerous forum posts.

    viagra doses how many milligrams jelqing viagra
    buy viagra online
    horseracing and italy and viagra – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  6. Your comment is awaiting moderation.

    Fantastic information. Appreciate it!

    viagra find sites free generic brand viagra
    viagra online
    viagra bastard – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  7. Your comment is awaiting moderation.

    You made your position quite nicely!!

    certified canadian viagra viagra gay
    buy viagra
    viagra best place – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  8. Your comment is awaiting moderation.

    Fantastic content. Regards.

    cheapest place to buy viagra online viagra lavitra cialis
    viagra without a doctors prescription
    lifestyles viagra – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  9. Your comment is awaiting moderation.

    Amazing plenty of great info!

    how does viagra cause blindness viagra pic
    viagra without a doctors prescription
    viagra print ad – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  10. Your comment is awaiting moderation.

    Seriously loads of awesome knowledge!

    viagra generic cialis drug interractions flomax viagra
    generic viagra
    natural compounds in viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  11. Your comment is awaiting moderation.

    Great posts. With thanks.

    purchasing viagra in malaysia does watermelon rhine work like viagra
    viagra without a doctors prescription
    research on copd and viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  12. Your comment is awaiting moderation.

    Amazing all kinds of amazing knowledge.

    viagra libre suisse viagra without prescription free
    viagra online
    viagra levitra strength – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  13. Your comment is awaiting moderation.

    Nicely put, Thanks a lot.

    sublingual viagra viagra after effects
    buy viagra online
    what drug is like viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  14. Your comment is awaiting moderation.

    With thanks! Plenty of write ups!

    order viagra now viagra money order viagra leicester po box
    buy viagra
    generic viagra scam – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  15. Your comment is awaiting moderation.

    Regards, Awesome stuff.

    viagra stories internet sales viagra
    viagra pills
    maximum dose viagra – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  16. Your comment is awaiting moderation.

    Good stuff. Cheers!

    aol email sending viagra adds pulmonary hypertension and viagra
    viagra without a doctor prescription
    viagra benefits – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  17. Your comment is awaiting moderation.

    You actually reported it superbly.

    viagra success pictures viagra levitra difference info
    buy generic viagra
    enlish suppliers of viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  18. Your comment is awaiting moderation.

    You have made the point!

    air order travel viagra videos what will 200mg of viagra do
    generic viagra online
    rapid viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  19. Your comment is awaiting moderation.

    Regards, Fantastic information.

    medication viagra making the most of viagra
    buy generic viagra
    back generic guarantee money viagra – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  20. Your comment is awaiting moderation.

    Truly quite a lot of useful knowledge.

    is viagra effected by grapefruit juice lowest price viagra online
    viagra pills
    viagra from indiana pharmacy – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  21. Your comment is awaiting moderation.

    Incredible lots of wonderful info!

    ordering viagra from uk reviews viagra tribulus
    viagra pills
    images of viagra – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  22. Your comment is awaiting moderation.

    You said it very well.!

    generic viagra is safe viagra without a prescription legal
    buy generic viagra
    viagra and children – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  23. Your comment is awaiting moderation.

    You have made your position very clearly..

    patrick adler kamagra generic viagra stroke impotence viagra
    viagra generic
    viagra femdom – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  24. Your comment is awaiting moderation.

    Really quite a lot of valuable tips.

    maximum dose viagra viagra us forums
    generic viagra 100mg
    generic viagra and china – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  25. Your comment is awaiting moderation.

    You said this perfectly!

    viagra with out a prescription shewing viagra
    viagra without a doctor prescription
    viagra erectile dysfunction – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  26. Your comment is awaiting moderation.

    Awesome postings. Many thanks.

    cialis levitra link viagra blogspot com viagra suppliers uk
    generic viagra 100mg
    viagra caffeine – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  27. Your comment is awaiting moderation.

    Nicely put. With thanks!

    on viagra viagra sexual enhancement
    cheap viagra
    2buy levitra viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  28. Your comment is awaiting moderation.

    Thanks a lot, Plenty of tips!

    levitra cialis and viagra 700 million classaction lawsuit against viagra
    generic viagra online
    is it safe to crush viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  29. Your comment is awaiting moderation.

    Amazing all kinds of wonderful knowledge!

    cheap viagra ambien generic cananda cheap geneirc viagra 100
    viagra for sale uk
    viagra ad email norton – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  30. Your comment is awaiting moderation.

    Superb data. Many thanks!

    viagra and hypertension subaction showcomments viagra start from older
    viagra without a doctor prescription
    marketing viagra to baby boomers – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  31. Your comment is awaiting moderation.

    You actually mentioned that exceptionally well.

    viagra alternetives is generic viagra legitimate
    buy viagra
    amoxicillin and viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  32. Your comment is awaiting moderation.

    Whoa many of excellent data!

    cheapest viagra in the world viagra cialis kamagra
    generic viagra 100mg
    wine bottle opener tablet viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  33. Your comment is awaiting moderation.

    Wow many of valuable information!

    site viagra viagra adds itself to contact list
    generic viagra 100mg
    buy drug generic generic online viagra – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  34. Your comment is awaiting moderation.

    Amazing postings. Cheers.

    viagra increaser mixing zanidip and viagra
    buy viagra
    lowest prices on generic viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  35. Your comment is awaiting moderation.

    You suggested this really well!

    viagra mastercard viagra online online a href iframe
    viagra for sale uk
    viagra maximum dosage – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  36. Your comment is awaiting moderation.

    You revealed that wonderfully.

    feedblitz news edinburgh pages viagra viagra cialis generic
    buy viagra online
    when to use viagra – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  37. Your comment is awaiting moderation.

    Reliable forum posts. Thanks!

    cheap viagra online without prescritpion how long does viagra work
    generic viagra
    viagra nutritional supplements – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  38. Your comment is awaiting moderation.

    Thank you! I enjoy it!

    tulip viagra viagra pill spliting
    viagra online
    purchase of viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  39. Your comment is awaiting moderation.

    Tips clearly applied.!

    generic sample pacs of viagra funny viagra pics
    generic viagra
    liquid viagra dauquiri recipe – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  40. Your comment is awaiting moderation.

    Cheers, Plenty of stuff!

    viagra best price on net scam cheapest viagra
    viagra generic
    cheap viagra generic – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  41. Your comment is awaiting moderation.

    Amazing stuff. Cheers!

    cheap viagra soft viagra delivered in 24 hours
    buy viagra
    healthy loss viagra weight – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  42. Your comment is awaiting moderation.

    With thanks. Plenty of material.

    viagra golf viagra france
    viagra online
    viagra tampa – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  43. Your comment is awaiting moderation.

    Nicely put, Cheers.

    water soluble viagra bob viagra
    buy viagra online
    nasal viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  44. Your comment is awaiting moderation.

    Cheers. Loads of information.

    does medicare rx cover viagra viagra premature ejaculations
    viagra for women
    viagra sales wallmart – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  45. Your comment is awaiting moderation.

    Wow tons of terrific info!

    web viagra subaction showcomments viagra optional online
    buy generic viagra
    save on viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  46. Your comment is awaiting moderation.

    Seriously plenty of excellent knowledge!

    where to buy viagra in bangkok buy viagra in the netherlands
    buy viagra
    viagra 6 free samples – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  47. Your comment is awaiting moderation.

    Great forum posts, Cheers!

    how to stop viagra emails taking viagra
    viagra 100mg
    viagra available safe – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  48. Your comment is awaiting moderation.

    Nicely spoken without a doubt! !

    free sex viagra sideeffects of viagra
    viagra 100mg
    viagra kitchen commercial – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  49. Your comment is awaiting moderation.

    Whoa many of valuable tips!

    generic softtabs viagra viagra cost compare
    viagra online
    buy brand name viagra – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

  50. Your comment is awaiting moderation.

    You reported it perfectly!

    viagra adverrtising pfizer drug viagra
    generic viagra 100mg
    viagra with sex – https://genericviagrarcp.com

    KeithEvics
    RichardCoick
    ErnestoNof

  51. Your comment is awaiting moderation.

    Appreciate it, Plenty of advice.

    viagra for her viagra vidrgne
    buy generic viagra
    canadian pharmacy generic viagra – https://genericviagrantx.com

    KeithEvics
    RichardCoick
    ErnestoNof

  52. Your comment is awaiting moderation.

    Truly a lot of fantastic tips.

    viagra afghanies bid 2836 viagra
    viagra for women
    find sites search viagra computer – https://genericviagramsl.com

    KeithEvics
    RichardCoick
    ErnestoNof

Speak Your Mind

*

Share This