Long-term follow-up of off-pump and on-pump coronary artery bypass grafting

Innovations (Phila). 2014 Mar-Apr;9(2):122-9; discussion 129. doi: 10.1097/IMI.0000000000000042.

Abstract

Objective: Despite increasing recognition of the benefits of off-pump coronary artery bypass grafting (CABG), concerns persist regarding its impact on long-term mortality and freedom from reintervention. In this study, we assessed the impact of off-pump CABG on long-term outcomes.

Methods: From January 2002 to December 2002, a total of 307 consecutive patients who underwent isolated multivessel off-pump CABG at our institution were compared with a control group of 397 patients who underwent multivessel on-pump CABG during the same period. Perioperative data were prospectively collected and compared. In addition, univariate and risk-adjusted comparisons between the two groups were performed at 10 years.

Results: After adjusting for clinical covariates, off-pump CABG did not emerge as a significant independent predictor of long-term mortality [hazard ratio (HR), 0.91; 95% confidence interval (CI), 0.70-1.12], readmission to hospital for cardiac cause (HR, 0.96; 95% CI, 0.78-1.10), or the need for reintervention (HR, 0.93; 95% CI, 0.87-1.05).

Conclusions: At long-term follow-up, off-pump CABG remains a safe and effective myocardial revascularization strategy with no adverse impact on survival or freedom from reintervention.

Publication types

  • Comparative Study

MeSH terms

  • Coronary Artery Bypass / methods*
  • Coronary Artery Bypass, Off-Pump / methods
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Time Factors
  • Treatment Outcome
  • United Kingdom / epidemiology