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High OPCAB surgical volume improves midterm event-free survival
Marco Agostini1, Carlo Fino, Pierfederico Torchio
1Cardiovascular Department, S. Croce e Carle Hospital, Cuneo, Italy. agostini.m@ospedale.cuneo.it
The Heart Surgery Forum
|October 17, 2009
Summary
Off-pump coronary artery bypass (OPCAB) surgery adoption showed midterm benefits when performed by high-volume surgeons. High-volume OPCAB and complete revascularization reduced major adverse cardiac events.
Area of Science:
- Cardiovascular Surgery
- Surgical Outcomes
- Cardiac Procedures
Background:
- Evaluating midterm outcomes of initial off-pump coronary artery bypass (OPCAB) surgery adoption.
- Assessing the impact of procedural volume on OPCAB in a single surgical unit.
Purpose of the Study:
- To assess the midterm results of off-pump coronary artery bypass (OPCAB) surgery.
- To evaluate the influence of surgeon volume on OPCAB outcomes.
Main Methods:
- Retrospective analysis of 312 patients undergoing OPCAB (August 2000 - January 2005).
- Comparison between OPCAB performed by 4 low-volume surgeons (126 patients) and 1 high-volume surgeon (186 patients).
Main Results:
- Low-volume surgeons used less arterial conduits and achieved less complete revascularization.
- High-volume surgeon performance and complete revascularization were protective against midterm major adverse cardiac events (MACE).
- 5-year survival rate was 0.88.
Conclusions:
- Initial phase of OPCAB adoption indicates midterm outcome benefits with high-volume surgeons.
- Surgeon experience is a critical factor for successful OPCAB adoption and patient outcomes.