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Invited Commentary
November 2013

On- or Off-Pump Coronary Artery Bypass Grafting: How Are You Trending?

Author Affiliations
  • 1Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
JAMA Surg. 2013;148(11):1036. doi:10.1001/jamasurg.2013.3610

In the ongoing effort to improve the care of our patients, certain dogmas are continually examined and questioned. Well over a decade ago, the need to place a patient on cardiopulmonary bypass (the pump) to arrest the heart to perform coronary artery bypass grafting was challenged. The techniques and maneuvers required, along with the marketing of a variety of devices to aid in the procedure, were widely disseminated. The requisite comparison studies then ensued, pitting the benefits of avoiding the adverse effects or complications associated with the pump against the potential for less than optimal grafting with its associated long-term problems. In the end, the practicing cardiac surgeon had to make a decision about how to perform the most common operation in our specialty.

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