Related Experiment Video
Updated: Aug 14, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Propensity score-matched comparison of total arterial off- and on-pump coronary artery bypass with complete
Shizuya Shintomi1, Satoshi Saito2, Azumi Hamasaki2
1Department of Cardiovascular Surgery, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjuku, Tokyo, Japan. shizuyashintomi@yahoo.co.jp.
Insights
Long-term outcomes after total arterial coronary artery bypass grafting (CABG) were similar for on-pump (ONCAB) and off-pump (OPCAB) procedures. Renal failure requiring dialysis emerged as a key risk factor for mortality and major adverse cardiac and cerebrovascular events (MACCEs).
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes Research
- Vascular Grafting
Background:
- Limited data exists on long-term outcomes (>10 years) and risk factors for total arterial coronary artery bypass grafting (CABG).
- Understanding differences between on-pump CABG (ONCAB) and off-pump CABG (OPCAB) is crucial for patient management.
Purpose of the Study:
- To evaluate long-term outcomes and identify risk factors for mortality and major adverse cardiac and cerebrovascular events (MACCEs).
- To compare outcomes between total arterial ONCAB and OPCAB with complete revascularization.
Main Methods:
- Retrospective cohort analysis of 401 patients undergoing primary total arterial CABG (July 2000 - June 2019).
- Propensity score matching (PSM) was used to compare outcomes between matched OPCAB (n=88) and ONCAB (n=88) groups.
- Univariate and multivariate analyses identified risk factors for mortality and MACCEs.
Main Results:
- No significant differences in all-cause mortality (HR 1.04) or MACCE incidence (HR 1.06) were observed between OPCAB and ONCAB groups after PSM.
- The mean follow-up period was 7.9 ± 6.3 years.
- Renal failure requiring dialysis was a significant risk factor for both mortality (p<0.0001) and MACCEs (p=0.0003).
Conclusions:
- Total arterial OPCAB and ONCAB with complete revascularization demonstrate similar long-term outcomes.
- Renal failure requiring dialysis is a critical independent risk factor for adverse outcomes following total arterial CABG.
Abstract:
Little is known regarding the long-term (> 10 years) outcomes and risk factors of total arterial coronary artery bypass grafting (CABG). This study evaluated the long-term outcomes and risk factors for all-cause mortality and major adverse cardiac and cerebrovascular events (MACCEs) following total arterial on-pump CABG (ONCAB) or off-pump CABG (OPCAB) with complete revascularization. This retrospective cohort analysis enrolled patients with stable angina who underwent total arterial CABG with complete revascularization in our institute between July 2000 and June 2019. The endpoints were all-cause mortality and MACCE incidence, including a comparison between OPCAB and ONCAB. Long-term (10-year) outcomes were analyzed using propensity score-matched pairs, and risk factors were evaluated using univariate and multivariate analyses. Overall, 401 patients who underwent primary total arterial CABG were classified into the OPCAB (n = 269) and ONCAB (n = 132) groups. Using propensity score matching (PSM), 88 patients who underwent OPCAB were matched with 88 patients who underwent ONCAB. The mean follow-up period was 7.9 ± 6.3 years. No significant difference in all-cause mortality (hazard ratio, 1.04; 95% confidence interval, 0.53-2.04; p = 0.9138) and MACCE incidence (hazard ratio, 1.06; 95% confidence interval, 0.68-1.65; p = 0.7901) was observed between the two groups. Renal failure requiring dialysis was a significant risk factor for mortality (p < 0.0001) and MACCEs (p = 0.0003). Long-term outcomes of total arterial OPCAB and ONCAB with complete revascularization showed similar findings using PSM. Renal failure requiring dialysis was a significant risk factor for mortality and morbidity.Journal standard instruction requires an unstructured abstract; hence the headings provided in abstract were deleted. Kindly check and confirm.Thank you for your kindness.Clinical registration number 5598, Tokyo Women's Medical University Hospital.
Related Concept Videos
01:29Blood Flow
01:14Overview of Blood Vessels
Arteries and Arterioles: Arteries are muscular and elastic vessels that primarily carry oxygenated blood from the heart to body tissues, except for the pulmonary artery, which carries deoxygenated blood. They have thick walls to withstand high pressure and contain a layer of muscle tissue, allowing them to expand or contract as...