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Off-pump coronary surgery in a single center experience: from selective to systematic use
Giovanni Troise1, Federico Brunelli, Marco Cirillo
1Cardiac Surgery Unit, Poliambulanza Hospital, Brescia, Italy. cch-segreteria.poli@poliambulanza.it
Summary
Systematic off-pump coronary artery bypass grafting is feasible and safe. This myocardial revascularization technique shows satisfactory early and intermediate outcomes, comparable to traditional methods.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Investigating the feasibility of systematic off-pump coronary artery bypass grafting (OPCAB).
- Comparing OPCAB with traditional on-pump coronary artery bypass grafting (CABG).
Purpose of the Study:
- To evaluate the feasibility and outcomes of systematically employing the off-pump technique for myocardial revascularization.
- To compare the safety and efficacy of OPCAB versus on-pump CABG.
Main Methods:
- A consecutive series of 1221 isolated coronary artery bypass grafting operations were performed.
- 771 procedures used cardiopulmonary bypass (Group A), and 450 were performed off-pump (Group B) using specialized instrumentation.
- Patients were considered for OPCAB starting July 2000.
Main Results:
- Off-pump surgery (Group B) showed significantly lower bleeding, transfusion rates, intubation time, and hospital stay.
- Hospital mortality, perioperative myocardial infarction, and cerebrovascular accidents were comparable between groups.
- Long-term follow-up revealed similar mortality, angina recurrence, and revascularization rates, with comparable survival curves.
Conclusions:
- Systematic implementation of off-pump coronary artery bypass grafting is feasible.
- Early and intermediate clinical results of OPCAB are satisfactory and comparable to on-pump procedures.