Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Puskas and colleagues1 reported that patients who underwent off-pump coronary
artery bypass graft (CABG) surgery had similar degrees of 1-year graft patency,
as well as similar 30-day and 1-year health-related quality of life, as patients
who underwent on-pump CABG surgery. I am concerned that the authors did not
describe the details of perfusion technique. There have been major changes
in techniques in reducing priming volumes as well as use of low-prime circuits.2 Pump runs with high volumes of crystalloid are
likely to be associated with significantly different oucomes than those with
low volumes. It is possible that results for on-pump and off-pump CABG surgery
were confounded with perfusion practice.
Patel K. On-Pump vs Off-Pump Coronary Artery Bypass Grafting. JAMA. 2004;292(2):169. doi:10.1001/jama.292.2.169-c