Cited by 209Cardiac and Coronary Surgery TechniquesBlood transfusion and managementTransplantation: Methods and Outcomes

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Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress

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Biglioli, P·2003·European Journal of Cardio-Thoracic Surgery

DOI 10.1016/s1010-7940(03)00295-1

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Abstract

Cardiopulmonary bypass (CPB) has been recognized as a cause of complex systemic inflammatory response, which significantly contributes to several adverse postoperative complications. In the last few years, off-pump coronary artery bypass grafting has gained widespread diffusion as an alternative technique to conventional on-pump coronary artery bypass grafting. Surgeons supporting off-pump surgery state that the avoidance of the CPB and myocardial ischemia-reperfusion significantly reduces the postoperative systemic inflammatory response and other biological derangements and, possibly, may improve the clinical outcomes. We review, here, the available evidence concerning possible differences between off-pump and on-pump procedures in terms of inflammation, hemostasis and oxidative stress. Consistent differences in the involvement of these systems are observed, but they are limited to the final steps of the surgical procedures and the early hours after. These findings suggest that the global surgical trauma may be as important, or even more, as the CPB in terms of systemic inflammatory and coagulation-fibrinolytic pathway activation. Further studies are needed in order to confirm this hypothesis.

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Proteomic Analysis of Plasma from Patients Undergoing Coronary Artery Bypass Grafting Reveals a Protease/Antiprotease Imbalance in Favor of the Serpin α1-Antichymotrypsin
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Hemostatic changes and clinical sequelae after on-pump compared with off-pump coronary artery bypass surgery: a prospective randomized study
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Advanced oxidation protein products as prognostic biomarkers for recovery from acute kidney injury after coronary artery bypass grafting
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The use of ultrafiltration for inflammatory mediators removal during cardiopulmonary bypass in coronary artery bypass graf surgery
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“Nonrandomized studies have shown a marked difference in complement activation (C3a, C5a) between on-pump and off-pump CPB patients [7].”
Background
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Oxidant Status following Cardiac Surgery with Phosphorylcholine‐Coated Extracorporeal Circulation Systems
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Authors: Biglioli, P.
Affiliations: University of Milan (IT)
Corresponding author: Biglioli, P
Venue: European Journal of Cardio-Thoracic Surgery
Publisher: Oxford University Press (OUP)
Published: 2003-08
Volume: 24
Issue: 2
Pages: 260-269
ISSN: 1010-7940 (ISSN-L)
DOI: 10.1016/s1010-7940(03)00295-1
OpenAlex: W2098507195
Cited by: 209
References: 66
Citations by year: 2026: 3 · 2025: 9 · 2024: 9 · 2023: 6 · 2022: 4 · 2021: 5 · 2020: 7 · 2019: 7 · 2018: 2 · 2017: 7 · 2016: 11 · 2015: 7 · 2014: 11 · 2013: 5 · 2012: 13
FWCI: 10.55
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: European Journal of Cardio-Thoracic Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Health Sciences › Medicine › Hematology › Blood transfusion and management
Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Keywords: off-pump coronary artery bypass, on-pump coronary artery bypass grafting, cardiopulmonary bypass, systemic inflammatory response, hemostasis, oxidative stress, myocardial ischemia-reperfusion injury, postoperative complications, surgical trauma
MeSH terms: C-Reactive Protein, Cardiopulmonary Bypass, Complement Activation, Coronary Disease, Fibrinolysis, Heart-Assist Devices, Hemostasis, Humans, Inflammation, Interleukins, Leukocytes, Pancreatic Elastase, Platelet Aggregation, Time Factors, Tumor Necrosis Factor-alpha, Biomarkers, Oxidative Stress

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Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress

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