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Updated: May 12, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Clinical outcome and quality of life after reoperative CABG: off-pump versus on-pump - observational pilot study
Engin Usta1, Raoof Elkrinawi, Adrian Ursulescu
1Department of Cardiac and Vascular Surgery, Robert-Bosch-Hospital, Auerbachstr 110, Stuttgart D-70376, Germany. engin.usta@gmx.de
Insights
Reoperative coronary artery bypass grafting (redo-CABG) using off-pump (OPCAB) techniques showed improved survival rates compared to on-pump (ONCAB) methods. While OPCAB offers benefits like reduced complications, both approaches had similar impacts on patient quality of life.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) on cardiopulmonary bypass (CBP) is linked to significant morbidity and mortality.
- Adverse effects of CBP may be more pronounced in high-risk patients requiring reoperation (redo-CABG).
Purpose of the Study:
- To evaluate the outcomes of reoperative CABG (redo-CABG) using either off-pump (OPCAB) or on-pump (ONCAB) techniques.
- To compare clinical endpoints including perioperative myocardial infarction, mortality, survival, and quality of life (QoL).
Main Methods:
- A prospective, non-randomized assessment of 80 patients undergoing redo-CABG between January 2007 and December 2010.
- Patients were divided into redo-OPCAB (n=40) and redo-ONCAB (n=40) groups.
- Quality of life was assessed using the SF-36 health survey.
Main Results:
- The redo-OPCAB group exhibited significantly shorter operation times, less blood loss, fewer perioperative myocardial infarctions, a higher rate of totally arterial revascularization, and shorter intensive care unit stays.
- Three-year survival rates were higher in the redo-OPCAB group (81 ± 12%) compared to the redo-ONCAB group (63 ± 9%).
- No significant differences in quality of life were found between the two groups.
Conclusions:
- The redo-OPCAB technique is safe and effective for reoperative CABG, demonstrating a higher 3-year survival rate.
- Both redo-OPCAB and redo-ONCAB techniques appear to have similar impacts on overall patient outcomes.
- Further retrospective study confirms the efficacy of redo-OPCAB.
Background:
Coronary artery bypass grafting (CABG) on cardiopulmonary bypass (CBP) is associated with significant morbidity and mortality. In high-risk patients, doomed for reoperation the adverse effects of CBP may be more striking. We evaluated the results of reoperative CABG (redo-CABG) by either off-pump (OPCAB) or on-pump (ONCAB). Clinical endpoints were perioperative myocardial infarction, mortality, survival and as the most striking difference between prior studies the quality of life (QoL).
Methods:
We performed a prospective, non-randomized assessment for patients who underwent redo-CABG by redo-OPCAB (n=40) or redo-ONCAB (n=40) at our institution between January 2007 and December 2010. For evaluation of QoL the SF-36 health survey was used with self-administered assessment.
Results:
During follow-up 37 of 40 patients were alive in the redo-OPCAB group versus 32 of 40 patients in the redo-ONCAB group (p<0.05). The shorter operation time, less blood loss, fewer perioperative myocardial infarctions, the higher rate of totally arterial revascularisation and shorter intensive care stay were the significantly beneficial differences for patients in the redo-OPCAB group (p<0.05). The 3-year survival rate was higher in the redo-OPCAB group with 81 ± 12% versus 63 ± 9%in the redo-ONCAB group. The quality of life survey did not reveal any significant differences between both groups.
Conclusion:
In conclusion, with our present retrospective study, we could demonstrate the safety and efficacy of the redo-OPCAB technique with even higher 3-year survival rate. Both techniques seem to have similar impact on the outcome of patients.
