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British Journal of Anaesthesia, 2004, Vol. 92, No. 3 324-326
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial II

Anaesthesia for off-pump coronary artery surgery

A. Kelleher1 and J. Gothard1

1 Department of Anaesthesia, The Royal Brompton Hospital, London SW3 6NP, UK E-mail: j.gothard{at}rbh.nthames.nhs.uk

The first 10% of the full text of this article appears below.

It is widely accepted that the use of cardiopulmonary bypass for cardiac surgery is associated with significant morbidity, in particular that secondary to activation of the inflammatory and coagulation systems. It is therefore surprising that almost a decade after the establishment of equipment and surgical techniques enabling coronary artery surgery to be routinely performed without cardiopulmonary bypass, evidence to demonstrate its superiority in all but high-risk patient populations remains controversial. This may, in part, be because the techniques involved are technically demanding with a substantial learning curve. In addition, it is likely that the physiological and pathological processes occurring during coronary artery surgery, whether with cardiopulmonary bypass or without, are more complex than has been previously thought. Many of the trials published relating to off-pump cardiac surgery (OPCAB) are case series, often compared with historical controls, and are . . . [Full Text of this Article]


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