Off Pumpp Case Study

The conventional on pump CABG employed CPB to extracorporeal oxygenate the venous blood through the machine and then pump the blood back to the patient while the surgeon perform anastomosis between a graft and a coronary artery. During the surgical procedure, a cross-clamping was applied on the aortic artery to provide myocardial protection, and the heart was induced to cardioplegia with drugs, so the surgeon can perform anastomosis on a motionless field, thus guaranteeing the quality of the anastomosis. However, the prolonged blood contact with CPB circuit can easily induce an impaired hemostasis and a systemic inflammatory response (Al-Attar, 2007). It also has many other complications such as adverse neurological outcome, renal dysfunction, increased stroke incidence, …show more content…
Cumulative convincing data indicate that off pump CABG significantly reduced the adverse effect caused by the CPB bump, such as the reduced inflammatory response, renal dysfunction, incidence of stroke and cognitive problems, reduced coagulopathy and blood transfusion requirement, reduced length of intensive care and hospital stay, etc (Al-Attar, 2007). Dr. Byrne and Dr. Leacche reported that the Off-pump CABG can significantly reduce the adverse neurological outcomes by lowering the stroke incidence, reducing renal failure and mortality compared to conventional on pump CABG (2017). Off pump CABG also minimized the aortic manipulation, thus reducing the risk of stroke, as the risk of the stroke related to the extent of aortic manipulation (Redaelli, Gamba, Martino, & Triggiani, 2017). The meta-analysis report from 100 studies with 19192 subjects published at 2016 confirmed this stroke reducing beneficial results (Kowalewski, et al.,