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European Heart Journal Advance Access originally published online on March 16, 2008
European Heart Journal 2008 29(11):1346-1349; doi:10.1093/eurheartj/ehn128
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Off pump coronary artery bypass: a passing fad or ready for prime time?

Norman Briffa1,2,*

1 South Yorkshire Cardiothoracic Centre, STH NHS Trust, Chesterman Wing, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
2 University of Sheffield, Sheffield, UK

Received 18 February 2008; accepted 29 February 2008; online publish-ahead-of-print 16 March 2008.

* Corresponding author. Tel: +44 1142266786, Fax: +44 1142610350, Email: norman.briffa{at}sth.nhs.uk

Off pump coronary artery bypass (OPCAB) allows multivessel coronary disease to be bypassed surgically without the need for cardiopulmonary bypass, myocardial ischaemia, and in many cases ascending aortic manipulation. Many randomized controlled studies of OPCAB vs. on pump CABG (coronary artery bypass grafting) have been completed and published. Although non-inferior, OPCAB does not, in these trials, offer any clear benefits. As a consequence, surgeons and industry are losing interest in this undeniably harder technique. As the risk profile of patients being referred for coronary surgery is increasing, is it time for OPCAB to prove itself? A large, appropriately powered randomized controlled trial of OPCAB vs. on pump CABG in high-risk patients will determine whether it is now or never for OPCAB.

Key Words: Coronary disease • Surgery • Bypass • Cardiopulmonary bypass


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