Department of Biosurgery and Surgical Technology, Imperial College London, London, United Kingdom.
Ann Thorac Surg. 2011 Aug;92(2):755-61. doi: 10.1016/j.athoracsur.2011.05.037.
The relative efficacy of off-pump and on-pump coronary revascularization is uncertain. A complication of off-pump surgery which is rarely considered is intraoperative conversion to cardiopulmonary bypass. Consequently, meta-analysis was performed of studies comparing morbidity after converted and nonconverted off-pump coronary revascularization. There were significant increases in the likelihood of stroke, myocardial injury, bleeding, renal failure, wound infection, intraaortic balloon pump requirement, transfusion, and respiratory and gastrointestinal complications after conversion. The underlying mechanisms need to be urgently elucidated. Prevention and treatment protocols for conversion warrant serious consideration and the risk of conversion may need to be discussed when obtaining informed patient consent.
不停跳搭桥术和体外循环搭桥术的相对疗效尚不确定。体外循环搭桥术很少考虑的一个并发症是术中转为体外循环。因此，对比较转为体外循环和未转为体外循环的不停跳搭桥术后发病率的研究进行了荟萃分析。转为体外循环后，中风、心肌损伤、出血、肾衰竭、伤口感染、主动脉内球囊泵需求、输血以及呼吸和胃肠道并发症的可能性显著增加。需要迫切阐明其潜在机制。对转为体外循环的预防和治疗方案需要认真考虑，在获得患者知情同意时可能需要讨论转为体外循环的风险。
