title: Midterm angiographic results of off-pump coronary artery bypass grafting.
abstract: BACKGROUND
  As off-pump coronary artery bypass grafting (OPCAB) has gained wide attention, the quality of surgical revascularization, which showed favorable initial results, is being frequently questioned. This study was undertaken to assess the midterm outcome of beating-heart coronary anastomosis.
  
  
  METHODS
  Seventy-four of 315 patients who underwent beating-heart coronary artery bypass grafting via median sternotomy between March 1994 and December 1995 were randomly selected for angiographic assessment.
  
  
  RESULTS
  The mean period of control angiography was 50.1 +/- 22.6 months (range, 22 to 83 months). A total of 109 (1.52 +/- 0.55) anastomosis procedures were performed in 74 patients; 38 had single-vessel disease, and 36 had double-vessel disease or disease involving more than 2 vessels. There were no perioperative returns to cardiopulmonary bypass, no major complications, and no hospital deaths. The causes of the need for occlusion included 2 (2.5%) instances of left internal mammary artery-left anterior descending artery anastomosis; 2 (2.5%) of anastomotic site stenosis in left internal mammary artery-left anterior descending artery anastomosis; 7 (19.4%) of saphenous vein graft anastomosis; and 3 (8.3%) of anastomotic site stenosis of saphenous vein graft. Statistical analysis revealed hypercholesterolemia as an independent predictor for graft occlusion (P =.014). The patency rates were not affected by endarterectomy, length of the anastomosed segment, or coronary artery structure. Event-free survival was 73.61% and myocardial infarction-free survival was 91.67%. Reintervention and reoperation rates were 24.3% (18 instances) and 1.4% (1 instance), respectively.
  
  
  CONCLUSIONS
  Our results were encouraging for OPCAB, supporting its safety and effectiveness, patency rates and clinical outcome comparable to those of cardiopulmonary bypass, and overall benefits such as reduced hospital costs and postoperative length of stay.
authors.affiliation: Department of Cardiovascular Surgery, Bayindir Hospital, Atatürk Sitesi Camuk Apt C Blok No 3, OR-AN 06450, Ankara, Turkey. borafarsak@isnet.net.tr
authors.forename: Bora
authors.initials: B
authors.lastname: Farsak
authors.forename: Serdar
authors.initials: S
authors.lastname: Günaydin
authors.forename: Ozer
authors.initials: O
authors.lastname: Kandemir
authors.forename: Hilmi
authors.initials: H
authors.lastname: Tokmakoglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Aydin
authors.forename: Cem
authors.initials: C
authors.lastname: Yorgancioglu
authors.forename: Kaya
authors.initials: K
authors.lastname: Süzer
authors.forename: Yaman
authors.initials: Y
authors.lastname: Zorlutuna
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors