Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark,
Curr Cardiol Rep. 2014 Mar;16(3):455. doi: 10.1007/s11886-013-0455-2.
Coronary artery bypass grafting (CABG) remains the preferred treatment in patients with complex coronary artery disease. However, whether the procedure should be performed with or without the use of cardiopulmonary bypass, referred to as off-pump and on-pump CABG, is still up for debate. Intuitively, avoidance of cardiopulmonary bypass seems beneficial as the systemic inflammatory response from extracorporeal circulation is omitted, but no single randomized trial has been able to prove off-pump CABG superior to on-pump CABG as regards the hard outcomes death, stroke or myocardial infarction. In contrast, off-pump CABG is technically more challenging and may be associated with increased risk of incomplete revascularization. The purpose of the review is to summarize the current literature comparing outcomes of off-pump versus on-pump coronary artery bypass surgery.
冠状动脉旁路移植术（CABG）仍然是治疗复杂冠状动脉疾病患者的首选方法。然而，是否应在体外循环（即非体外循环和体外循环 CABG）的情况下进行该手术仍存在争议。直观地说，避免体外循环似乎是有益的，因为可以避免体外循环引起的全身炎症反应，但没有一项随机试验能够证明非体外循环 CABG 在死亡、卒中和心肌梗死等硬终点方面优于体外循环 CABG。相比之下，非体外循环 CABG 技术上更具挑战性，并且可能与不完全血运重建的风险增加相关。本综述的目的是总结比较非体外循环与体外循环冠状动脉旁路移植术结果的现有文献。
