10-year follow-up of off-pump multivessel coronary artery bypass grafting

On-pump total arterial grafting is associated with improved long-term outcomes compared to conventional grafting using left internal thoracic artery and saphenous vein grafts, but there are no data to confirm the same for off-pump total arterial grafting. We assessed the impact of off-pump total arterial grafting on medium-term outcomes. From September 1998 to September 2008, 580 consecutive patients who had off-pump multivessel arterial grafting only were compared with a control group of 806 patients undergoing off-pump coronary artery bypass with internal thoracic artery and saphenous vein grafts, performed by the same surgeon. Perioperative data were collected prospectively. Medium-term univariate and risk-adjusted comparisons between the 2 groups were carried out. After adjusting for clinical covariates, total arterial grafting did not emerge as a significant independent predictor of medium-term mortality, readmission to hospital, or the composite outcome of death and readmission. At medium-term follow-up, off-pump total arterial grafting, despite being a safe and effective myocardial revascularization strategy, offered no mortality or morbidity benefits.