Clinical outcomes of coronary revascularization without cardiopulmonary bypass.
OBJECTIVE
Coronary artery bypass without cardiopulmonary bypass (OPCAB) eliminates the complications related to cardiopulmonary bypass. However, the long-term outcomes of this procedure are largely unknown.


METHODS
We sought to investigate the rates of late mortality, stroke, acute myocardial infarction, and target vessel reintervention after OPCAB in a consecutive series of 857 patients who underwent OPCAB between May 1987 and March 1999.


RESULTS
Long-term follow-up was obtained for 86% of eligible patients. Actuarial and event-free survival was 89% and 76%, respectively, for a median follow-up period of 2.2 years (range, 0-13.3 years). Risk factors for late mortality were identified with Cox regression analysis. In the multivariate analysis, patient age >75 years (odds ratio, 1.1; 95% confidence interval, 1.0-1.1; P =.01) and an ejection fraction <35% (odds ratio, 2.7; 95% confidence interval, 1.2-6.2; P =.02) emerged as independent predictors of late mortality.


CONCLUSIONS
OPCAB is associated with a low mortality and clinical event rate. Advanced age and depressed ejection fraction may increase mortality after OPCAB.
Stamou
Sotiris C
SC
Section of Cardiac Surgery, Georgetown University Hospital, Washington, DC, USA.
Pfister
Albert J
AJ
Jablonski
Kathleen A
KA
Hill
Peter C
PC
Dullum
Mercedes K C
MK
Bafi
Ammar S
AS
Boyce
Steven W
SW
Garcia
Jorge M
JM
Lomax
Tracie A
TA
Corso
Paul J
PJ
D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001281:Atrial Fibrillation / Q000209:etiology; D002315:Cardiopulmonary Bypass; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D013318:Stroke Volume; D016019:Survival Analysis; D016896:Treatment Outcome