Off-pump coronary artery bypass: early results

Ann Thorac Cardiovasc Surg. 2000 Apr;6(2):110-8.

Abstract

Background: Coronary artery bypass grafting (CABG) on a beating-heart has gained the attention of cardiac surgeons and shown favorable initial results. However, only a few follow-up results have been reported. We report herein our one-year experiences of off-pump CABG performed at Shin-Tokyo Hospital.

Methods: Retrospective chart review was performed for patients who underwent off-pump CABG and conventional isolated CABG between 01/01/98 and 12/31/98. Preoperative, perioperative, and follow-up data were collected.

Results: Among 315 cases of isolated CABG, 94 cases were off-pump CABG (male/female 69/25, mean age 67.7). Mean number of distal anastomoses performed by off-pump CABG was 1.7 +/- 0.7 (42 cases of single-vessel revascularization and 52 cases of more than double- vessel revascularization). In off-pump CABG, there were no hospital deaths and 6 major complications including 2 incidences of perioperative myocardial infarction. Postoperative angiography before hospital discharge was performed in 56 patients (59.6%, 98 anastomosis) and revealed 5 occlusions, giving a graft patency rate of 94.9%. During the follow-up (11.4 +/- 4.1 months), there was 1 late non-cardiac death and 11 cardiac events. The event-free rate at 18 months was 94.0% in off-pump CABG, showing no significant difference from the event-free rate after conventional CABG (94.0% at 18 months, p = 0.135). Follow-up angiography was performed in 21 patients (33 anastomoses) at a mean interval of 3.6 months and showed 4 graft occlusions, giving a patency rate of 92.7%.

Conclusion: Both hospital and early results of off-pump CABG were acceptable. Off-pump CABG can be safely performed in selected patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiopulmonary Bypass*
  • Contraindications
  • Coronary Angiography
  • Coronary Artery Bypass* / mortality
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / mortality
  • Coronary Disease / surgery*
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Minimally Invasive Surgical Procedures / mortality
  • Postoperative Complications / epidemiology
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Thoracotomy
  • Treatment Outcome