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dc.contributor.authorKing, N
dc.contributor.authorMann, V
dc.date.accessioned2018-11-23T16:15:47Z
dc.date.issued2018-10-19
dc.identifier.issn1945-4589
dc.identifier.issn1945-4589
dc.identifier.urihttp://hdl.handle.net/10026.1/12863
dc.description.abstract

For the past 3 decades there has been a heated controversy in the world of coronary artery bypass graft (CABG) surgery. This has concerned whether to perform CABG with (on pump) or without (off pump) cardiopulmonary bypass. Each technique has advantages and shortcomings. For example on pump has often been associated with a small risk of stroke, whereas off pump reduces aortic manipulation [1]. Both approaches have been implicated in a systemic inflammatory response [1]. Despite >60 meta-analyses investigating this topic no conclusive answer has been reached and the debate continues [1]. Two of the problems encountered when seeking evidence are the sparsity of large randomised controlled trials (RCTs) and a focus on short-term clinical outcomes. A possible resolution to the latter was the long awaited publication of the five-year outcomes of two of the largest RCTs to date, ROOBY (Randomized on/off bypass) [2] and CORONARY (CABG off or on pump revascularization) [3] trials. This enabled a fresh metaanalysis investigating long-term clinical outcomes (mortality, myocardial infarction, stroke, angina and the need for revascularisation) incorporating 6 RCTs, and, most importantly, including ROOBY and CORONARY. The results showed a small but significant benefit of on pump in terms of mortality with all other comparisons showing no differences [4]. This raises a new question what is the reason/mechanism underlying on pump’s seemingly superior long-term survival rate?

dc.format.extent2553-2554
dc.format.mediumPrint
dc.languageen
dc.language.isoen
dc.publisherImpact Journals
dc.subjectcardiopulmonary bypass
dc.subjectcognitive decline
dc.subjectcoronary artery bypass grafting
dc.subjectmortality
dc.subjectoff pump
dc.titleWhy do on-pump patients live longer?
dc.typejournal-article
dc.typeEditorial
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/30341254
plymouth.issue10
plymouth.volume10
plymouth.publication-statusPublished
plymouth.journalAging
dc.identifier.doi10.18632/aging.101607
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/School of Biomedical Sciences
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeUnited States
dcterms.dateAccepted2018-10-18
dc.rights.embargodate2018-12-14
dc.identifier.eissn1945-4589
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.18632/aging.101607
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-10-19
rioxxterms.typeJournal Article/Review


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