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Hypercoagulable state after off-pump coronary artery bypass grafting: evidence, mechanisms and implications.
MedLine Citation:
PMID:  21615323     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
During the past decade, there has been a dramatic resurgence in the adoption of off-pump technology in coronary artery bypass surgery. This has inspired remarkable advances in the techniques of localized tissue stabilization and a greater understanding of the physiology of beating-heart mobilization and exposure. An avalanche of reports in the literature has demonstrated the early safety and efficacy of the procedure. However, despite abundant evidence validating the safety and efficacy of off-pump coronary artery bypass surgery, considerable controversy still persists regarding the long-term outcomes of this approach to myocardial revascularization. One area of concern, and even greater uncertainty, surrounds the issue of the existence of a hypercoagulable state after off-pump coronary artery bypass surgery. This article evaluates the current best evidence available from randomized controlled trials to assess the impact of off-pump coronary artery bypass surgery on coagulation, fibrinolysis and platelet activation, discusses the issue of hypercoagulability with emphasis on the mechanisms responsible for this actual or potential hypercoagulability, and explores the implications of this issue for clinical practice.
Authors:
Shahzad G Raja; Shamim Akhtar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  9     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  599-608     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Harefield Hospital, Hill End Road, Harefield, London, UB9 6JH, UK. drrajashahzad@hotmail.com.
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