Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

’Off-pump’ bypass surgery has similar outcomes, lower cost, than conventional bypass surgery

21.04.2004


Coronary artery surgery performed "off-pump", i.e., keeping the heart beating and not using the cardiopulmonary bypass machine, has similar outcomes after one year, and costs less, when compared to conventional coronary artery bypass grafting (CABG) using cardiopulmonary bypass, according to a study in the April 21 issue of The Journal of the American Medical Association (JAMA).



To try to avoid some of the complications attributable to cardiopulmonary bypass, U.S. surgeons performed approximately 21 percent of coronary artery bypass operations off-pump in 2002, according to background information in the article. In off-pump operations, the heart is kept beating, and with the help of a device, the beating heart is stabilized while the surgeon places the bypass grafts around the blocked arteries. During a conventional CABG surgery, a heart-lung machine allows the heart to stop and pumps blood throughout the body, and keeps the body stabilized. Concerns remains about the technical difficulty of off-pump coronary artery bypass (OPCAB), including the possibility of imprecise grafting and incomplete revascularization compromising patient outcomes, and long-term graft patency (keeping the graft open).

John D. Puskas, M.D., M.Sc., of the Emory University School of Medicine and Emory Center for Outcomes Research, Atlanta, and colleagues conducted the Surgical Management of Arterial Revascularization Therapies (SMART) trial, designed to compare graft patency, clinical outcomes, health-related quality of life, and costs in unselected patients referred for elective, isolated CABG surgery and randomized to OPCAB or CABG with cardiopulmonary bypass. The study included 197 patients who had follow-up at 30 days; 185 of those had follow-up at 1 year. The study was conducted between March 10, 2000, and August 20, 2001, at a U.S. academic center.


The researchers found that graft patency was similar for OPCAB and conventional CABG with cardiopulmonary bypass at 30 days and at 1 year. Rates of death, stroke, heart attack, angina, and reintervention were similar at 30 days and 1 year. "There were no significant differences in health-related quality of life. Mean total hospitalization cost per patient at hospital discharge was $2,272 less for OPCAB and $1,955 less at 1 year," the authors write.

"These results from the SMART trial demonstrate that OPCAB may provide complete revascularization that is durable and cost-effective relative to CABG with cardiopulmonary bypass when performed on unselected patients undergoing elective, isolated CABG," the researchers conclude.

(JAMA. 2004;291:1841-1849. Available post-embargo at JAMA.com)

Cindy Sanders | EurekAlert!
Further information:
http://jama.com

More articles from Health and Medicine:

nachricht Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences

nachricht What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Argon is not the 'dope' for metallic hydrogen

24.03.2017 | Materials Sciences

Astronomers find unexpected, dust-obscured star formation in distant galaxy

24.03.2017 | Physics and Astronomy

Gravitational wave kicks monster black hole out of galactic core

24.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>