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[PDF: Members Only] J.Jpn. Surg. Soc.. 124(4): 324-331, 2023
Feature topic
OFF-PUMP VERSUS ON-PUMP CORONARY ARTERY BYPASS GRAFTING
Off-pump coronary artery bypass grafting (CABG) was revised and rapidly developed in the early 2000s aiming to reduce the deleterious effects of cardiopulmonary bypass. Currently in Japan, 57% of isolated CABG is performed using the off-pump technique with satisfactory early postoperative outcomes. Although early studies appeared to show better outcomes such as reduction of stroke risk, especially for high-risk patients, large randomized controlled trials and meta-analyses have failed to demonstrate an advantage of off-pump over on-pump CABG in the long-term outcomes. Surgeons’ experience in off-pump CABG may be associated with late mortality. In experienced hands, off-pump CABG can achieve long-term outcomes comparable to those observed after on-pump CABG and can therefore be considered as a valid alternative to the on-pump procedure. It will be crucial to pass experts’ techniques of off-pump CABG from first-generation surgeons to the next generation.
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