title: Comparison of off-pump and conventional coronary endarterectomy.
abstract: OBJECTIVE
  This study was designed to compare the early and midterm results of off-pump coronary endarterectomy (OPCE) with those of conventional coronary endarterectomy (CCE) performed with cardiopulmonary bypass.
  
  
  METHODS
  From April 1, 1999, until March 1, 2001, 332 patients underwent off-pump coronary artery bypass grafting at our institution. From this total, 44 (13%) of the patients underwent supplementary OPCE (group 1). The results were compared with those for a group of age-, sex-, and risk factor-matched patients undergoing CCE (group 2) at the same institution. The mean follow-up period was 16 months. The indications for operation in group 1 were angina in 16 (36%) of the cases, cardiac failure in 20 (45%), and prognosis in 8 (19%). In group 2 angina was the indication for operation in 11 (25%) of the cases, cardiac failure in 5 (11%), and prognosis in 30 (64%) of the cases.
  
  
  RESULTS
  In group 1, 35 patients underwent single and 9 underwent double endarterectomy. The procedures included 32 right coronary artery, 12 left anterior descending artery, 2 lateral circumflex artery, and 7 diagonal branch operations. Three (6.8%) of the patients in group 1 and 2 (4.4%) of the patients in group 2 developed postoperative myocardial infarction (P <.05). One (2.2%) of the patients in group 1 and 2 (4.4%) of the patients in group 2 died in the postoperative period (P <.05). The numbers of patients with perioperative neurologic deficit in groups 1 and 2 were 0 and 7, respectively (P <.001). Although the rate of perioperative myocardial infarction was higher in group 1, mortality, occurrence of other morbid events, intubation time, intensive care stay, and hospital length of stay were less in group 1 than group 2.
  
  
  CONCLUSIONS
  OPCE can be performed safely with morbidity and mortality comparable with those of CCE.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Academic Hospital, Istanbul, Turkey. enaseri@turk.net
authors.forename: Erdinç
authors.initials: E
authors.lastname: Naseri
authors.forename: Meral
authors.initials: M
authors.lastname: Sevinç
authors.forename: M Kamuran
authors.initials: MK
authors.lastname: Erk
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016022:Case-Control Studies; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D004691:Endarterectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome