title: Earlier recovery with beating-heart surgery: a comparison of 300 patients undergoing conventional versus off-pump coronary artery bypass graft surgery.
abstract: 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.
authors.affiliation: Department of Surgery, University Hospital of Cleveland, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA. jai.lee@uhhs.com
authors.forename: Jai H
authors.initials: JH
authors.lastname: Lee
authors.forename: Michelle
authors.initials: M
authors.lastname: Capdeville
authors.forename: Dale
authors.initials: D
authors.lastname: Marsh
authors.forename: Khaled
authors.initials: K
authors.lastname: Abdelhady
authors.forename: Ahmad
authors.initials: A
authors.lastname: Poostizadeh
authors.forename: Helen
authors.initials: H
authors.lastname: Murrell
mesh_terms: 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