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(Circulation. 2007;116:1755.)
© 2007 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	PROSPECTIVE RANDOMIZED COMPARISON OF CORONARY BYPASS GRAFTING WITH MINIMAL EXTRACORPOREAL CIRCULATION SYSTEM (MECC) VERSUS OFF-PUMP CORONARY SURGERY, by Mazzei et al

 
Two approaches have been developed as attempts to retain the positive features of cardiopulmonary bypass, especially in the area of completeness and durability of coronary revascularization, while avoiding some of its negative features. The latter can include systemic inflammatory response as well as untoward neurological events resulting from the manipulation of the aorta required by the procedure. Off-pump coronary bypass grafting (OPCABG), in experienced hands, has demonstrated benefits in certain patient groups in terms of hospital length of stay, short-to-intermediate term survival, and neurologic complications. Mini-bypass circuits, minimal extracorporeal circulation (MECC), have been developed in an attempt to retain the beneficial features of cardiopulmonary bypass while limiting the undesirable features of OPCABG, namely, systemic inflammatory response, coagulopathy, and hemodilution. In this issue of Circulation, Mazzei and colleagues report a prospective randomized study comparing OPCABG and MECC in a series of nearly 400 patients. The study demonstrates comparable operative mortality and morbidity and similar release of inflammatory markers, length of hospital stay, and use of blood products. Residual perfusion defects and occluded/stenotic bypass grafts at 1 year are similar between groups, and coronary revascularization was performed with equal efficacy by experienced surgeons employing either MECC or OPCABG. Thus, these results suggest that MECC may achieve the benefits of OPCABG while facilitating more complete revascularization. See p 1761.

	TWENTY-FIVE–YEAR EXPERIENCE WITH THE MEDTRONIC-HALL VALVE PROSTHESIS IN THE AORTIC POSITION, by Svennevig et al

 
This study is a retrospective analysis of 816 patients who underwent aortic valve replacement with the Medtronic-Hall valve prosthesis between 1977 and 1987 at Rikshospitalet in Oslo, Norway. Svennevig and colleagues followed . . . [Full Text of this Article]

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