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Updated: Jun 2, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Resource utilization in off-pump versus conventional coronary artery bypass grafting in a community hospital: a
Scot C Schultz1, Scott Woodward, George Ebra
1Gulf Coast Cardiothoracic and Vascular Surgeons, Naples, Florida Naples Community Hospital, Naples, FL, USA. canes99@yahoo.com
Insights
Off-pump coronary artery bypass (OPCAB) is a safe and effective myocardial revascularization procedure. Compared to conventional coronary artery bypass (CCAB), OPCAB shows reduced morbidity, mortality, and resource utilization.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Minimally Invasive Cardiac Procedures
Background:
- Coronary artery bypass grafting is a prevalent cardiac surgical procedure globally.
- Healthcare cost containment is a significant concern in medical procedures.
- This study addresses the comparative effectiveness of OPCAB versus CCAB.
Purpose of the Study:
- To compare 30-day mortality and morbidity between OPCAB and CCAB.
- To evaluate resource utilization for both surgical approaches.
- To assess the safety and efficacy of OPCAB for myocardial revascularization.
Main Methods:
- Retrospective analysis of a prospectively collected dataset (2000-2008).
- 1003 patients underwent OPCAB by a single surgeon.
- Propensity-matching techniques were used to compare OPCAB with 1003 CCAB patients.
Main Results:
- Lower hospital mortality for OPCAB (2.0%) versus CCAB (2.8%).
- OPCAB demonstrated reduced overall morbidity, including less reoperation for bleeding, prolonged ventilation, stroke, and cardiac arrest.
- OPCAB patients had shorter procedure times, ventilation durations, hospital stays, and reduced blood product usage.
Conclusions:
- OPCAB is a safe and effective procedure for myocardial revascularization.
- This study indicates reduced morbidity and mortality with OPCAB compared to CCAB.
- OPCAB is associated with decreased healthcare resource utilization.
Background:
At a time when cost containment in health care is under increased scrutiny, coronary artery bypass grafting remains the most widely performed cardiac surgical procedure in the world. This study compares 30-day mortality, morbidity, and resource use for off-pump coronary artery bypass (OPCAB) versus conventional coronary artery bypass (CCAB) revascularization.
Methods:
From January 2000 through December 2008, 1003 patients underwent OPCAB grafting by a single surgeon (S.C.S.). Data were prospectively collected, entered into a Society of Thoracic Surgeons adult cardiac surgery database, and analyzed retrospectively. We used propensity-matching techniques to match this cohort to a group of 1003 patients who underwent CCAB.
Results:
The hospital mortality rate was lower for the OPCAB patients than for the CCAB patients: 2.0% (20/1003) versus 2.8% (28/1003). Predictors of hospital mortality for the entire cohort included age (P = .001), cardiogenic shock (P = .001), congestive heart failure (P = .019), history of myocardial infarction (P = .001), and reoperation (P = .007). The overall incidence of morbidity was lower for the OPCAB patients (reoperation for bleeding, P = .011; prolonged ventilation, P = .035; stroke, P = .045; cardiac arrest, P = .004). OPCAB patients experienced significantly reduced procedure times (P = .001), postoperative ventilation times (P = .035), post-operative lengths of stay (P = .035), and blood product use (intraoperative, P = .001; postoperative, P = .001).
Conclusion:
These outcomes clearly demonstrate that OPCAB is a safe and effective procedure for myocardial revascularization. This retrospective, nonrandomized observational study has shown that the patients who underwent OPCAB had reduced morbidity and mortality, as well as decreased resource use, compared with those who underwent CCAB.
