The Journal of Thoracic and Cardiovascular Surgery
Volume 126, Issue 1 , Pages 7-10 , July 2003

Is there a hypercoagulable state after off-pump coronary artery bypass surgery? What do we know and what can we do?

  • Paul A. Kurlansky, MD

      Affiliations

    • Miami Heart Research Institute, Miami Beach, Fla, USA.
    • Corresponding Author InformationAddress for reprints: Paul A. Kurlansky, MD, Miami Heart Research Institute, 801 Arthur Godfrey Rd, 5th Floor, Miami Beach, FL 33140, USA

Received 18 September 2002 ,Accepted 23 September 2002.

References 

  1. Kolessov VI. Mammary artery-coronary artery anastomosis as a method of treatment for angina pectoris. J Thorac Cardiovasc Surg. 1967;54:535–544
  2. Favaloro RG, Effler DB, Groves LK, Shelton WC, Sones FM. Direct myocardial revascularization by saphenous vein graft. Present operative techniques and indications. Ann Thorac Surg. 1970;10:97–111
  3. Hart JC, Puskas JD, Sabik JF. Off-pump coronary revascularization (current state of the art). Semin Thorac Cardiovasc Surg. 2002;14:70–81
  4. Gardner TJ. Off-pump CABG safer for the brain. Presented at 81st Annual Meeting of The American Association for Thoracic Surgery, May 9, 2001, San Diego, California
  5. Mariani AM, Gu J, Boonstra PW, et al.  Procoagulant activity after off-pump coronary operation (is the current anticoagulation adequate?). Ann Thorac Surg. 1999;67:1370–1375
  6. Mack JM, Magovern JA, Acuff TA, et al.  Results of graft patency by immediate angiography in minimally invasive coronary artery surgery. Ann Thorac Surg. 1999;68:383–390
  7. Izzat MB, Khaw KS, Atassi W, Yim AP, Wan S, El-Zufari MH. Routine intraoperative angiography improves the early patency of coronary grafts performed on the beating heart. Chest. 1999;115:987–990
  8. Diegeler A, Matin M, Kayser S, et al.  Angiographic results after minimally invasive bypass grafting using the minimally invasive direct coronary bypass grafting (MIDCAB) approach. Eur J Cardiothorac Surg. 1999;15:680–684
  9. Akpinar B, Guden M, Sagbas E, Sanisoglu I, Aytekin V, Bayindir O. Off-pump coronary artery bypass grafting with use of the octopus 2 stabilization system. Heart Surg Forum. 2000;3:282–286
  10. Omeroglu SN, Kirali K, Guler M, et al.  Midterm angiographic assessment of coronary artery bypass grafting without cardiopulmonary bypass. Ann Thorac Surg. 2000;70:844–850
  11. Zehr KJ, Handa N, Bonilla LF, Abel MD, Holmes DR. Pitfalls and results of immediate angiography after off-pump coronary artery bypass grafting. Heart Surg Forum. 2000;3:293–299
  12. Amano A, Hirose H, Takahashi A, Nagano N. Off-pump coronary artery bypass. Mid-term results. Jpn J Thorac Cardiovasc Surg. 2001;49:67–78
  13. Bull DA, Neumayer LA, Stringham JC, et al.  Coronary artery bypass grafting with cardiopulmonary bypass versus off-pump cardiopulmonary bypass grafting (does eliminating the pump reduce morbidity and cost?). Ann Thorac Surg. 2001;71:170–175
  14. Kim KB, Lim C, Lee C, et al.  Off-pump coronary artery bypass may decrease the patency of saphenous vein grafts. Ann Thorac Surg. 2001;72:S1033–1037
  15. Puskas JD, Thourani VH, Marshall JJ, et al.  Clinical outcomes, angiographic patency, and resource utilization in 200 consecutive off-pump coronary bypass patients. Ann Thorac Surg. 2001;71:1477–1484
  16. Motwani JG, Topol EJ. Aortocoronary saphenous vein graft disease (pathogenesis, predisposition and prevention). Circulation. 1998;97:916–931
  17. Casati V, Gerli C, Franco A, et al.  Activation of coagulation and fibrinolysis during coronary surgery (on-pump versus off-pump techniques). Anesthesiology. 2001;95:1103–1109
  18. Moor E, Blombac M, Silveira A, et al.  Haemostatic function in patients undergoing coronary artery bypass grafting (perioperative perturbations and relations to saphenous vein graft closure). Thromb Res. 2000;98:39–49
  19. Lytle BW, Loop FD, Cosgrove DM, et al.  Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts. J Thorac Cardiovasc Surg. 1985;89:248–258
  20. Angelini GD, Taylor FC, Reeves BC, Ascione R. Early and midterm outcome after off-pump and on-pump surgery in beating heart against cardioplegic arrest studies (BHACAS 1 and 2) (a pooled analysis of two randomized controlled trials). Lancet. 2002;359:1194–1199
  21. D’Ancona G, Donias HW, Karamanoukian RL, et al.  OPCAB therapy survey (off-pump clopidogrel, aspirin or both therapy survey). Heart Surg Forum. 2001;4:354–358
  22. Nader ND, Khadra WZ, Reich NT, Bacon DR, Salerno TA, Panos AL. Blood product use in cardiac revascularization (comparison of on-and off-pump techniques). Ann Thorac Surg. 1999;68:1640–1643
  23. Steinhubl SR. Antiplatelet agents in cardiology (the choice of therapy). Ann Thorac Surg. 2000;70:S3–8
  24. Schomig A, Neumann F-J, Kastrati A, et al.  A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med. 1996;334:1084–1089
  25. Bhatt DL, Chew DP, Hirsch AT, Ringleb PA, Hacke W, Topol EJ. Superiority of clopidogrel versus aspirin in patients with prior cardiac surgery. Circulation. 2001;103:363–368
  26. Teirstein PS. Living the dream of no restenosis. Circulation. 2001;104:1996–1998
  27. Mangi AA, Dzau VJ. Gene therapy for human bypass grafts. Ann Med. 2001;33:153–155

☆ Presented at The Evolution of Facilitated Anastomoses, Four Seasons Resort, Aviara, North San Diego, Calif, April 5–7, 2002.

PII: S0022-5223(02)73472-7

doi: 10.1016/S0022-5223(02)73472-7

The Journal of Thoracic and Cardiovascular Surgery
Volume 126, Issue 1 , Pages 7-10 , July 2003

Article Tools