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Off-pump coronary artery bypass: early results
1Department of Cardiovascular Surgery, Shin-Tokyo Hospital, 473-1 Nemoto, Matsudo City, Chiba 271-0077, Japan.
Insights
Off-pump coronary artery bypass grafting (CABG) showed acceptable hospital and early results. This beating-heart surgery is safe for selected patients, with a 94.0% event-free rate at 18 months.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Techniques
- Minimally Invasive Cardiac Surgery
Background:
- Off-pump coronary artery bypass grafting (CABG) is gaining attention for its favorable initial outcomes.
- Limited long-term follow-up data exists for beating-heart CABG procedures.
- This study reports one-year experiences with off-pump CABG at Shin-Tokyo Hospital.
Purpose of the Study:
- To evaluate the one-year outcomes of off-pump CABG.
- To compare the safety and efficacy of off-pump CABG with conventional CABG.
- To assess graft patency rates and clinical event-free survival after off-pump CABG.
Main Methods:
- Retrospective chart review of patients undergoing isolated CABG between January 1, 1998, and December 31, 1998.
- Data collection included preoperative, perioperative, and follow-up information for both off-pump and conventional CABG groups.
- Angiography was performed postoperatively and during follow-up to assess graft patency.
Main Results:
- Out of 315 isolated CABG cases, 94 were performed off-pump (mean age 67.7 years).
- Off-pump CABG had no hospital deaths and a 94.9% early graft patency rate. The 18-month event-free rate was 94.0%.
- Follow-up angiography showed a 92.7% patency rate. No significant difference in event-free rates was observed compared to conventional CABG.
Conclusions:
- Off-pump CABG demonstrated acceptable hospital and early clinical outcomes.
- The procedure can be safely performed in selected patients.
- Off-pump CABG is a viable alternative to conventional CABG with comparable long-term results.
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.