Off-pump coronary artery bypass: early results.
BACKGROUND
Coronary artery bypass grafting (CABG) on a beating-heart has gained the attention of cardiac surgeons and shown favorable initial results. However, only a few follow-up results have been reported. We report herein our one-year experiences of off-pump CABG performed at Shin-Tokyo Hospital.


METHODS
Retrospective chart review was performed for patients who underwent off-pump CABG and conventional isolated CABG between 01/01/98 and 12/31/98. Preoperative, perioperative, and follow-up data were collected.


RESULTS
Among 315 cases of isolated CABG, 94 cases were off-pump CABG (male/female 69/25, mean age 67.7). Mean number of distal anastomoses performed by off-pump CABG was 1.7 +/- 0.7 (42 cases of single-vessel revascularization and 52 cases of more than double- vessel revascularization). In off-pump CABG, there were no hospital deaths and 6 major complications including 2 incidences of perioperative myocardial infarction. Postoperative angiography before hospital discharge was performed in 56 patients (59.6%, 98 anastomosis) and revealed 5 occlusions, giving a graft patency rate of 94.9%. During the follow-up (11.4 +/- 4.1 months), there was 1 late non-cardiac death and 11 cardiac events. The event-free rate at 18 months was 94.0% in off-pump CABG, showing no significant difference from the event-free rate after conventional CABG (94.0% at 18 months, p = 0.135). Follow-up angiography was performed in 21 patients (33 anastomoses) at a mean interval of 3.6 months and showed 4 graft occlusions, giving a patency rate of 92.7%.


CONCLUSIONS
Both hospital and early results of off-pump CABG were acceptable. Off-pump CABG can be safely performed in selected patients.
Hirose
H
H
Department of Cardiovascular Surgery, Shin-Tokyo Hospital, 473-1 Nemoto, Matsudo City, Chiba 271-0077, Japan.
Amano
A
A
Yoshida
S
S
Takahashi
A
A
Nagano
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass; D000075202:Contraindications; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000401:mortality; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013908:Thoracotomy; D016896:Treatment Outcome