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J Thorac Cardiovasc Surg 2009;137:1575-1576
© 2009 The American Association for Thoracic Surgery

Letter to the Editor

Changes in noninfarcted myocardium explain benefits of on-pump beating-heart coronary artery bypass grafting for acute myocardial infarction

The Alfred CJOB Cardiothoracic Surgery, Prahran, Victoria, Australia

The first 20% of the full text of this article appears below.

To the Editor:

We read with great interest the article by Miyahara and associates¹ comparing outcomes in patients undergoing emergency coronary artery bypass grafting (CABG) for acute myocardial infarction (MI), using on-pump beating-heart (OPBH) surgery, with outcomes of conventional CABG using aortic crossclamping and cardioplegia. This study is one of four published over the past 3 years reporting improved outcomes with this new technique.

These studies claim the avoidance of reperfusion injury after crossclamping of the aorta as the reason for the benefits seen. However, we believe an important concept has been overlooked here, namely, the effects of global ischemia on the noninfarcted myocardium. There is extensive evidence, . . . [Full Text of this Article]

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Reply to the Editor

Ken Miyahara, Akio Matsuura, Haruki Takemura, and Shunei Saito
J. Thorac. Cardiovasc. Surg. 2009 137: 1576-1577. [Extract] [Full Text] [PDF]