Trends in use of off-pump coronary artery bypass grafting: Results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database.

Published

Journal Article

OBJECTIVES: Recent national trends in off-pump versus on-pump coronary artery bypass grafting have not been reported. METHODS: We analyzed data from the Society of Thoracic Surgeons Adult Cardiac Surgery Database regarding isolated primary coronary artery bypass grafting operations (N = 2,137,841; 1997-2012). The off-pump percentages were calculated in aggregate, by center, and by surgeon. On the basis of the 2007/2008 yearly off-pump volume, the analysis subgroups were "high" (center n > 200, surgeon n > 100), "intermediate" (center n = 50-200, surgeon n = 20-100), and "low" (center n = 1-49, surgeon n = 1-19). RESULTS: The use of off-pump procedures peaked in 2002 (23%) and again in 2008 (21%), followed by a progressive decline in off-pump frequency to 17% by 2012. After 2008, off-pump rates declined among both high-volume and intermediate-volume centers and surgeons; little change was observed for low-volume centers or surgeons (off-pump rates = 10% since 2008). By the end of the study period, 84% of centers performed fewer than 50 off-pump cases per year, 34% of surgeons performed no off-pump operations, and 86% of surgeons performed fewer than 20 off-pump cases per year. Except for a higher (7.8%) conversion rate in 2003, the rate for conversions fluctuated approximately 6%. CONCLUSIONS: Enthusiasm for off-pump coronary artery bypass grafting has been tempered. The percentage of coronary artery bypass grafting operations performed off-pump has steadily declined over the last 5 years, and currently this technique is used in fewer than 1 in 5 patients who undergo surgical coronary revascularization. A minority of surgeons and centers continue to perform off-pump coronary artery bypass grafting in most of their patients.

Full Text

Duke Authors

Cited Authors

  • Bakaeen, FG; Shroyer, ALW; Gammie, JS; Sabik, JF; Cornwell, LD; Coselli, JS; Rosengart, TK; O'Brien, SM; Wallace, A; Shahian, DM; Grover, FL; Puskas, JD

Published Date

  • September 2014

Published In

Volume / Issue

  • 148 / 3

Start / End Page

  • 856 - 864.e1

PubMed ID

  • 25043865

Pubmed Central ID

  • 25043865

Electronic International Standard Serial Number (EISSN)

  • 1097-685X

Digital Object Identifier (DOI)

  • 10.1016/j.jtcvs.2013.12.047

Language

  • eng

Conference Location

  • United States