Abstract
Off-pump coronary artery bypass graft surgery is one the most effective method of treatment of ischemic heart disease. However,
safety and feasibility of this method are still an area of concerns and undergoing disputes. Most surgical revascularization procedures
are performed on-pump. But for the last 20 years coronary artery bypass graft surgery has been being more widely performed offpump
that is related to the unfavourable consequences of cardiopulmonary bypass and aortic manipulations. Refusal to perform cardiopulmonary
bypass give certain clinical benefits which were appealing to many researchers. The published data of numerous retrospective
randomized controlled clinical trials reported the results of performing off-pump coronary artery bypass (OPCAB) but
because of small sample sizes the difference between off-pump coronary artery bypass and the traditional coronary artery bypass
grafting (with cardiopulmonary bypass) was not demonstrated in the short- and long-term outcomes. The recent large-scale trials
showed more statistically significant and reliable short-term and long-term results of performing off-pump coronary artery bypass
(OPCAB), that indicated the advantage of this method compared with traditional coronary artery bypass grafting. The advantage
could be more evident in the patients at high risk of complications associated with cardiopulmonary bypass and atherosclerosis of
the ascending aorta and primarily is beneficial for reducing cerebrovascular adverse consequences. Short-term and long-term survival
rates for patients and reduction of the incidence of «coronary events» depend on the high performance of technical support during
surgery to deliver the best in patient care. The article considers current views regarding possibilities of off-pump coronary artery
bypass (OPCAB) in the treatment of patients with ischemic heart disease.
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