Generic placeholder image

Reviews on Recent Clinical Trials

Editor-in-Chief

ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

Systematic Review Article

Off-pump Techniques of Surgical Myocardial Revascularization

Author(s): Guglielmo Actis Dato* and Marco Picichè

Volume 14, Issue 2, 2019

Page: [116 - 119] Pages: 4

DOI: 10.2174/1574887114666190201112053

Price: $65

Abstract

Background: Before the advent of CABG, standardized in the late '60s by Favaloro and Effler, patients with myocardial ischemia underwent indirect and heterogeneous off-pump methods of myocardial revascularization.

Methods & Results: Indirect revascularization, such as periaortic nerve plexus interruption, Vineberg operation, Sen procedure and, less remotely, TMR Laser and stem cell transplantation, represented some of the ways to achieve myocardial revascularization. Nowadays, direct coronary revascularization is the only established technique and may be performed either on-pump or off-pump.

Conclusion: The comparison of off-pump and on-pump myocardial revascularization paved the way to an endless debate between the advantages and disadvantages of each technique. In this article, we review the old and current off-pump approaches of surgical myocardial revascularization.

Keywords: Cardiopulmonary bypass, collateral circulation, coronary, myocardium, off-pump, revascularization, surgery.

Graphical Abstract

[1]
Amano J, Kuwano H, Yokomise H. Thoracic and cardiovascular surgery in Japan during 2011: Annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg 2013; 61: 578-607.
[2]
Favaloro RG. Saphenous vein graft in the surgical treatment of coronary artery disease. Operative technique. J Thorac Cardiovasc Surg 1969; 58: 178.
[3]
Picichè M. The history of myocardial revascularization before the advent of cardiopulmonary bypass. In: Picichè M, Ed. Dawn and Evolution of Cardiac Procedures: Research Avenues in Cardiac Surgery and Interventional Cardiology. Springer-Verlag: Heidelberg 2012; pp. 65-77.
[4]
Beck CS. The development of a new blood supply to the heart by operation. Ann Surg 1935; 102: 801-13.
[5]
O’Shaughnessy L. The pathology and surgical treatment of cardiac ischemia. Bristol Med J 1937; 54: 109-26.
[6]
Lezius A. Die kunstliche Blutversorgung des Herzmuskels. ArchKlin Chir 1937; 189: 342-6.
[7]
Picichè M. Le défi de la revascularisation myocardique dans les années 1930 et 1940: Hommage à Claude Schaeffer Beck. Chirurgie Thoracique et Cardiovasculaire 2013; 17(4): 199-200.
[8]
Battezzati M, Tagliaferro A, De Marchi G. La legatura delle due arterie mammarie interne nei disturbi di vascolarizzazione del miocardio. Minn Med 1955; 46: 1178.
[9]
Arnulf G. La resection du pléxus pré-aortique dans l’angine de poitrine. J Chir 1950; 66: 97.
[10]
Actis Dato A. Nuova tecnica chirurgica per denervazione cardiaca totale nell’angina pectoris. Cardiol Prat 1967; 18: 55-60.
[11]
Vineberg AM. Development of an anastomosis between the coronary vessels and a transplanted internal mammary artery. Can Med Asscoc J 1946; 55: 181-9.
[12]
Sen PK, Udwadia TE, Kinare SG, Parulkar GB. Transmyocardial acupuncture: A new approach to myocardial recascularization. J Thorac Cardiovasc Surg 1965; 50: 181-9.
[13]
Mirhoseini M, Cayton MM. Revascularization of the heart by Laser. J Microsurg 1981; 2: 253-60.
[14]
Chu V, Kuang J, McGinn A, et al. Angiogenic response induced by mechanical transmyocardial revascularization. J Thorac Cardiovasc Surg 1999; 118: 849-56.
[15]
Sansone F, Actis Dato G, et al. Transmyocardial laser revascularization. personal experience. G Chir 2011; 32(11-12): 467-8.
[16]
Berenson RJ, Andrews RG, Besinger WI, et al. Antigen CD34+ marrow cells engraft lethally irradiated baboons. J Clin Invest 1988; 81: 951.
[17]
Burgess AW, Metcalf D. The nature and action of granulocytes-macrophage colony-stimulating factor. Blood 1980; 56: 947.
[18]
Actis Dato G, Sansone F, Omedé P, et al. Preoperative mobilization of bone marrow-derived cells followed by revascularization surgery: Early and long-term outcome. Int J Artif Organs 2012; 35(1): 67-76.
[19]
Picichè M, Fadel E, Kingma JG Jr, et al. Blood flow to the heart from noncoronary arteries: An intriguing but challenging research field. Cardiovasc Revasc Med 2012; 13(1): 25-9.
[20]
Picichè M, Kingma JJ, Fadel E, et al. Enhancement of noncoronary collateral blood flow from the internal thoracic arteries: The theoretical and practical basis of an alternative method of myocardial blood supply. J Cardiovasc Surg 2011; 52(1): 127-31.
[21]
Picichè M, Kingma JG, Fadel E, et al. Enhancement of noncoronary collateral circulation: The hypothesis of an alternative treatment for ischemic heart disease. Med Hypotheses 2000; 74: 21-3.
[22]
Picichè M. Embolization of the internal thoracic arteries in refractory angina. Int J Cardiol 2016; 212: 310.
[23]
Kolessov VI. Mammary artery-coronary artery anastomosis as a method of treatment for angina pectoris. J Thorac Cardiovasc Surg 1967; 54: 535.
[24]
Calafiore AM, Di Mauro M, Teodori G, et al. Impact of aortic manipulation on incidence of cerebrovascular accidents after surgical myocardial revascularization. Ann Thorac Surg 2002; 73: 1387-93.
[25]
Cavallaro P, Itagaki S, Seigerman M, et al. Operative mortality and stroke after on-pump vs off-pump surgery in high-risk patients: an analysis of 83,914 coronary bypass operations. Eur J Cardiothorac Surg 2014; 45: 159-64.
[26]
Cheng DC, Bainbridge D, Martin JE, Novick RJ. For the evidence-based perioperative clinical outcomes research group. does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials. Anesthesiology 2005; 102: 188-203.
[27]
Emmert MY, Salzberg SP, Seifert B, et al. Is off-pump superior to conventional coronary artery bypass grafting in diabetic patients with multivessel disease? Eur J Cardiothorac Surg 2011; 40: 233-9.
[28]
Feng ZZ, Shi J, Zhao XW, et al. Meta-analysis of on-pump and off-pump coronary arterial revascularization. Ann Thorac Surg 2009; 87: 757-65.
[29]
Moss E, Puskas JD, Thourani VH, et al. Avoiding aortic clamping during coronary artery bypass grafting reduces postoperative stroke. J Thorac Cardiovasc Surg 2015; 149(1): 175-80.
[30]
Nakano J, Okabayashi H, Noma H, et al. Early angiographic evaluation after off-pump coronary artery bypass grafting. J Thorac Cardiovasc Surg 2013; 146: 1119-25.
[31]
Nathoe HM, van Dijk D, Jansen EW. For the OCTOPUS Study Group. A comparison of on-pump and off-pump coronary bypass surgery in low-risk patients. N Engl J Med 2003; 348: 394-402.
[32]
Bassano C, Bovio E, Uva F, et al. Partially anaortic clampless off-pump coronary artery bypass prevents neurologic injury compared to on-pump coronary surgery: A propensity score-matched study on 286 patients. Heart Vessels 2016; 31(9): 1412-7.
[33]
Bassano C, Bovio E, Sperandio M, et al. Five-year clinical outcome and patency rate of device-dependent venous grafts after clampless OPCAB with PAS-port automated proximal anastomosis: the PAPA Study. J Card Surg 2014; 29(3): 325-32.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy