Document Detail


Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress.
MedLine Citation:
PMID:  12895618     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiopulmonary bypass (CPB) has been recognized as a cause of complex systemic inflammatory response, which significantly contributes to several adverse postoperative complications. In the last few years, off-pump coronary artery bypass grafting has gained widespread diffusion as an alternative technique to conventional on-pump coronary artery bypass grafting. Surgeons supporting off-pump surgery state that the avoidance of the CPB and myocardial ischemia-reperfusion significantly reduces the postoperative systemic inflammatory response and other biological derangements and, possibly, may improve the clinical outcomes. We review, here, the available evidence concerning possible differences between off-pump and on-pump procedures in terms of inflammation, hemostasis and oxidative stress. Consistent differences in the involvement of these systems are observed, but they are limited to the final steps of the surgical procedures and the early hours after. These findings suggest that the global surgical trauma may be as important, or even more, as the CPB in terms of systemic inflammatory and coagulation-fibrinolytic pathway activation. Further studies are needed in order to confirm this hypothesis.
Authors:
Paolo Biglioli; Aldo Cannata; Francesco Alamanni; Moreno Naliato; Massimo Porqueddu; Marco Zanobini; Elena Tremoli; Alessandro Parolari
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  24     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-04     Completed Date:  2003-11-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  260-9     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Centro Cardiologico Monzino IRCCS, University of Milan, via Parea 4, 20138 Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
C-Reactive Protein / analysis
Cardiopulmonary Bypass / adverse effects,  methods*
Complement Activation
Coronary Disease / immunology,  metabolism,  surgery*
Fibrinolysis
Heart-Assist Devices
Hemostasis
Humans
Inflammation / etiology
Interleukins / blood
Leukocytes / immunology
Oxidative Stress
Pancreatic Elastase / blood
Platelet Aggregation
Time Factors
Tumor Necrosis Factor-alpha / analysis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Interleukins; 0/Tumor Necrosis Factor-alpha; 9007-41-4/C-Reactive Protein; EC 3.4.21.36/Pancreatic Elastase

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