The systemic inflammatory response to cardiac surgery

Since aortic cross-clamping and CPB were universally used for all forms of cardiac surgery, their relative role in the pathogenesis of postoperative complications has been unclear. OPCAB will help to delineate the intrinsic effects of bypass on the inflammatory response to cardiac surgery. OPCAB and minimally invasive cardiac surgery have demonstrated encouraging short-term benefits in the small-scale clinical studies of low-risk patients carried out to date, but clinical studies have not been carried out in the high-risk groups most likely to benefit. Finally, concerns regarding the quality of graft anastomoses achieved with OPCAB or minimal access techniques remain to be addressed.