Earlier recovery with beating-heart surgery: a comparison of 300 patients undergoing conventional versus off-pump coronary artery bypass graft surgery.
OBJECTIVE
To compare outcomes and cost of off-pump coronary artery bypass (OP-CAB) surgery versus cardiopulmonary bypass-assisted coronary artery bypass graft (CABG) surgery.


METHODS
Retrospective review.


METHODS
A tertiary care university teaching hospital.


METHODS
Patients (n = 300) undergoing isolated CABG surgery performed by a single surgeon between July 1998 and February 2000.


METHODS
Two groups of patients were compared: 150 consecutive patients undergoing OP-CAB surgery and a matched cohort of 150 consecutive patients undergoing conventional CABG surgery.


RESULTS
The 2 groups were evenly matched in terms of age and incidence of diabetes, hypertension, peripheral vascular disease, left main disease, prior strokes, congestive heart failure, and recent infarctions. OP-CAB procedures required 3.3 grafts per patient versus 3.8 grafts per patient required for CABG surgery (p = 0.02). Overall mortality was 2.0% (1.3% in the OP-CAB surgery group v 2.7 % in the CABG surgery group; p = NS). Extubation times (6.6 hours v 9.5 hours; p = 0.003), surgical intensive care unit length of stay (39 hours v 49 hours; p = 0.03), and hospital length of stay (6.1 days v 7.0 days; p = 0.04) were all significantly shorter for the OP-CAB surgery group. The combined aggregate endpoints of death and major morbidity were significantly less in the OP-CAB surgery group (5.3% v 12.7%; p = 0.02).


CONCLUSIONS
OP-CAB surgery is associated with low morbidity and mortality and accelerated recovery compared with conventional CABG surgery. OP-CAB surgery may represent the ideal revascularization strategy for patients at high risk for undergoing cardiopulmonary bypass.
Lee
Jai H
JH
Department of Surgery, University Hospital of Cleveland, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. jai.lee@uhhs.com
Capdeville
Michelle
M
Marsh
Dale
D
Abdelhady
Khaled
K
Poostizadeh
Ahmad
A
Murrell
Helen
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000401:mortality; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate