Off pump coronary artery bypass grafting - midterm results

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery Outcomes
• Minimally Invasive Cardiac Surgery

Background:

• Off-pump coronary artery bypass (OPCAB) grafting remains a topic of debate within cardiac surgery.
• While early results are promising, mid-term data on angina recurrence and freedom from adverse events are less frequently reported.

Purpose of the Study:

• To evaluate mid-term clinical outcomes and graft patency following OPCAB grafting.
• To assess freedom from death and re-intervention in a consecutive OPCAB patient cohort.
• To analyze changes in angina and heart failure classifications post-OPCAB surgery.

Main Methods:

• A cohort of 107 OPCAB patients (mean age 63, 77% male) were systematically followed up.
• Pre- and post-operative NYHA and CCS classifications were compared.
• Freedom from death and re-intervention was assessed, with a subset undergoing angiography or MSCT.

Main Results:

• 30-day mortality was 2%. At 5.5 years, freedom from death was 91% and freedom from re-intervention was 80%.
• Significant reductions in CCS (2.8 to 1.8) and NYHA (2.7 to 2.2) classifications were observed.
• Graft patency rates at a mean follow-up of 2.2 years were 91% for LITA and 83% for venous grafts.

Conclusions:

• OPCAB grafting in this high-risk cohort demonstrates acceptable mid-term freedom from death and re-intervention.
• Sustained clinical improvement is evident through significant reductions in angina and heart failure symptoms.
• Graft patency rates are within the expected range, supporting the durability of OPCAB procedures.