Risk-adjusted short- and long-term outcomes for on-pump versus off-pump coronary artery bypass surgery.

Published

Journal Article

BACKGROUND: Surgeons have adopted off-pump coronary artery bypass grafting (OPCAB) in an effort to reduce the morbidity of surgical revascularization. However, long-term outcome of OPCAB compared with conventional coronary artery bypass grafting (CABG) remains poorly defined. METHODS AND RESULTS: Using logistic regression analysis and proportional hazards modeling, short-term and long-term outcomes (perioperative mortality and complications, risk-adjusted survival, and survival/freedom from revascularization) were investigated for patients who underwent OPCAB (641 patients) and CABG-cardiopulmonary bypass (5026 patients) from 1998 to 2003 at our institution. For these variables, follow-up was 98% complete. OPCAB patients were less likely to receive transfusion (odds ratio for OPCAB, 0.80; P=0.037), and there were trends toward improvement in other short-term outcomes compared with CABG-cardiopulmonary bypass. Long-term outcomes analysis demonstrated no difference in survival, but OPCAB patients were more likely to require repeat revascularization (OPCAB hazard ratio, 1.29; P=0.020). CONCLUSIONS: OPCAB patients were less likely to receive transfusion during their hospitalization for surgery but had higher risk for revascularization in follow-up. These results highlight the need for a large randomized, controlled trial to compare these 2 techniques.

Full Text

Duke Authors

Cited Authors

  • Williams, ML; Muhlbaier, LH; Schroder, JN; Hata, JA; Peterson, ED; Smith, PK; Landolfo, KP; Messier, RH; Davis, RD; Milano, CA

Published Date

  • August 30, 2005

Published In

Volume / Issue

  • 112 / 9 Suppl

Start / End Page

  • I366 - I370

PubMed ID

  • 16159847

Pubmed Central ID

  • 16159847

Electronic International Standard Serial Number (EISSN)

  • 1524-4539

Digital Object Identifier (DOI)

  • 10.1161/CIRCULATIONAHA.104.526012

Language

  • eng

Conference Location

  • United States