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July 14, 2004

On-Pump vs Off-Pump Coronary Artery Bypass Grafting

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;292(2):169. doi:10.1001/jama.292.2.169-c

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.