OBJECTIVE: Off-pump coronary artery bypass grafting (OPCAB) has become a procedure of choice for surgical treatment of coronary artery disease. Although early advantages of OPCAB were confirmed in comparison with conventional on-pump coronary artery bypass grafting (CABG), late cardiac complications are still controversial. We examined midterm results of OPCAB compared with standard CABG. METHODS: Between July 1997 and April 2002, 736 consecutive patients who underwent isolated CABG were retrospectively reviewed. The OPCAB group (Group I) comprised 357 patients (49%), and the on-pump CABG group (Group II) 379 patients (51%). Their preoperative, intraoperative, and follow-up data were analyzed. RESULTS: The mean number of distal anastomoses and the early graft patency were not greatly different between the two groups. The actuarial survival rate at 3 years was not significantly different between Group I (98.3%) and Group II (98.2%) (p = 0.71). The frequency of cardiac events was 4.2%/patient-year in Group I and 2.6%/patient-year in Group II (p = 0.12). The actuarial event free rates were not different between the two groups (p = 0.61). The cardiac event free rates at 3 years were significantly (p = 0.011) higher in patients with complete revascularization (96.7%) than without complete revascularization in Group I (69.2%) and in Group II (92.7% versus 85.9%, p = 0.026). CONCLUSIONS: Midterm clinical outcome in OPCAB is as good as conventional on-pump CABG. Incomplete revascularization caused cardiac events more frequently than complete revascularization both in OPCAB and on-pump CABG in the intermediate follow-up.
OBJECTIVE: Off-pump coronary artery bypass grafting (OPCAB) has become a procedure of choice for surgical treatment of coronary artery disease. Although early advantages of OPCAB were confirmed in comparison with conventional on-pump coronary artery bypass grafting (CABG), late cardiac complications are still controversial. We examined midterm results of OPCAB compared with standard CABG. METHODS: Between July 1997 and April 2002, 736 consecutive patients who underwent isolated CABG were retrospectively reviewed. The OPCAB group (Group I) comprised 357 patients (49%), and the on-pump CABG group (Group II) 379 patients (51%). Their preoperative, intraoperative, and follow-up data were analyzed. RESULTS: The mean number of distal anastomoses and the early graft patency were not greatly different between the two groups. The actuarial survival rate at 3 years was not significantly different between Group I (98.3%) and Group II (98.2%) (p = 0.71). The frequency of cardiac events was 4.2%/patient-year in Group I and 2.6%/patient-year in Group II (p = 0.12). The actuarial event free rates were not different between the two groups (p = 0.61). The cardiac event free rates at 3 years were significantly (p = 0.011) higher in patients with complete revascularization (96.7%) than without complete revascularization in Group I (69.2%) and in Group II (92.7% versus 85.9%, p = 0.026). CONCLUSIONS: Midterm clinical outcome in OPCAB is as good as conventional on-pump CABG. Incomplete revascularization caused cardiac events more frequently than complete revascularization both in OPCAB and on-pump CABG in the intermediate follow-up.
Authors: Sérgio A Oliveira; Luiz Augusto F Lisboa; Luís Alberto O Dallan; Salomon O Rojas; Luiz F Poli de Figueiredo Journal: Ann Thorac Surg Date: 2002-02 Impact factor: 4.330
Authors: N C Poirier; M Carrier; J Lespérance; G Côté; M Pellerin; L P Perrault; L C Pelletier Journal: J Thorac Cardiovasc Surg Date: 1999-02 Impact factor: 5.209
Authors: R Scott; E H Blackstone; P M McCarthy; B W Lytle; F D Loop; J A White; D M Cosgrove Journal: J Thorac Cardiovasc Surg Date: 2000-07 Impact factor: 5.209
Authors: D M Cosgrove; F D Loop; B W Lytle; C C Gill; L A Golding; C Gibson; R W Stewart; P C Taylor; M Goormastic Journal: Ann Surg Date: 1985-10 Impact factor: 12.969
Authors: Joseph F Sabik; A Marc Gillinov; Eugene H Blackstone; Catherine Vacha; Penny L Houghtaling; Jose Navia; Nicholas G Smedira; Patrick M McCarthy; Delos M Cosgrove; Bruce W Lytle Journal: J Thorac Cardiovasc Surg Date: 2002-10 Impact factor: 5.209