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Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

482
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Related Experiment Video

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Novel Triple-Loop Technique for Suturing TFCC Injuries without Transosseous Tunnel
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Off-pump no-touch technique: 3-year results compared with the SYNTAX trial.

Sara C Arrigoni1, Gianclaudio Mecozzi2, Jan G Grandjean2

  • 1Thoraxcenter, University Medical Center, Groningen, Netherlands s.c.arrigoni@umcg.nl.

Interactive Cardiovascular and Thoracic Surgery
|February 10, 2015
PubMed
Summary

Off-pump coronary artery bypass (OPCAB) no-touch surgery using arterial grafts demonstrated improved 3-year outcomes. This technique showed significantly lower major adverse cardiovascular and cerebrovascular events and repeat revascularization compared to SYNTAX trial arms.

Keywords:
Comparative studyCoronary artery anastomosisCoronary artery bypassInternal mammaryOff-pumpRadial artery

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Off-pump coronary artery bypass (OPCAB) surgery aims to reduce complications associated with cardiopulmonary bypass.
  • The no-touch technique utilizes arterial composite grafts, potentially offering superior long-term patency.
  • Comparison with established revascularization strategies like those in the SYNTAX trial is crucial for evaluating OPCAB efficacy.

Purpose of the Study:

  • To evaluate the 3-year clinical outcomes of OPCAB no-touch surgery with arterial composite grafts.
  • To indirectly compare these outcomes with the 3-year follow-up data from the SYNTAX trial.

Main Methods:

  • A retrospective analysis of 400 consecutive 'all-comers' undergoing OPCAB no-touch coronary surgery.
  • Primary endpoint: 3-year major adverse cardiovascular and cerebrovascular events (MACCE).
  • Indirect comparison of outcomes with randomized arms (coronary artery bypass grafting and percutaneous coronary intervention) of the SYNTAX trial.

Main Results:

  • 3-year survival was 82.2%, with 89.7% freedom from MACCE.
  • OPCAB no-touch group showed significantly lower MACCE (10.3%) and repeat revascularization (4.3%) compared to SYNTAX trial arms (20.2-28.0% MACCE, 10.7-19.7% revascularization).
  • Stroke rates were significantly lower in the OPCAB no-touch group versus the SYNTAX CABG arm (1.3% vs 3.4%) but not significantly different from the PCI arm (1.3% vs 2%).

Conclusions:

  • The OPCAB no-touch technique with arterial composite grafts is safe and effective at 3-year follow-up.
  • This technique may enhance patient outcomes by reducing morbidity and neurological complications.
  • Further prospective controlled trials are warranted to validate these findings.