Document Detail

The history and development of direct coronary surgery without cardiopulmonary bypass.
MedLine Citation:
PMID:  15548184     Owner:  NLM     Status:  MEDLINE    
The history of direct myocardial revascularization without cardiopulmonary bypass dates to 1961 in the dawn of coronary artery surgery. With the introduction and development of techniques of extracorporeal circulation around the same time, beating heart surgery was largely abandoned. Over the subsequent decades, cardiopulmonary bypass and electromechanical cardioplegic arrest became popular as means of revascularization in a bloodless and motionless field. While coronary artery surgery on the arrested heart remained undisputed for decades, myocardial revascularization on the beating heart was pursued by a few pioneering surgeons around the world, based on the belief that coronary revascularization could be performed equally well without the detrimental effects of cardiopulmonary bypass and electromechanical arrest. Various concepts and techniques developed during the 1980s by these pioneers enabled minimally invasive coronary surgery to be performed in the early 1990s. This break from the mainstream allowed selective myocardial revascularization using a minimal incision and no cardiopulmonary bypass to develop and constructed a base for future extensive revascularizations off-pump. With the subsequent explosion of new techniques for coronary exposure and myocardial stabilization, complete revascularization without cardiopulmonary bypass became possible with consistent results. Emerging from the preview of only a few surgeons just a decade ago, off-pump surgery is currently one of the accepted modalities for complete myocardial revascularization worldwide. This paradigm shift in the approach to myocardial revascularization has led to exiting new future possibilities, such as beating heart totally endoscopic coronary artery surgery.
Mohan Thanikachalam; Pierluca Lombardi; Hassan Y Tehrani; Kushagra Katariya; Tomas A Salerno
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  19     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2004-11-19     Completed Date:  2006-08-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  516-9     Citation Subset:  IM    
Division of Cardiothoracic Surgery, University of Miami, Jackson Memorial Hospital, Miami, Florida, USA.
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MeSH Terms
Cardiopulmonary Bypass / methods,  trends*
Coronary Artery Bypass / methods,  trends*
Coronary Artery Disease / surgery
Myocardial Revascularization / trends
North America

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