Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: In response to Mr Patel, we discussed
the conduct of perfusion in considerable detail in the preliminary report
from this study,1 which was cited extensively
in our current article. We do agree, however, that cardiopulmonary bypass
techniques and technologies have recently been the subject of significant
innovation, perhaps as a response to the perceived "threat" of off-pump CABG.
Low-prime circuits, retrograde autologous priming, coated tubing, and dilutional
ultrafiltration have recently demonstrated promise and are techniques and
technologies we and others currently use. However, during enrollment for our
trial, mini-primed circuits were in an early phase of development. Perfusion
techniques in our trial were state of the art at the time and were compared
with contemporary techniques for off-pump CABG.
Puskas JD, Palmer-Steele C. On-Pump vs Off-Pump Coronary Artery Bypass Grafting—Reply. JAMA. 2004;292(2):169. doi:10.1001/jama.292.2.169-d