title: Comparison of off-pump and on-pump coronary artery bypass grafting in midterm results.
abstract: OBJECTIVE
  Off-pump coronary artery bypass grafting (OPCAB) has become a procedure of choice for surgical treatment of coronary artery disease. Although early advantages of OPCAB were confirmed in comparison with conventional on-pump coronary artery bypass grafting (CABG), late cardiac complications are still controversial. We examined midterm results of OPCAB compared with standard CABG.
  
  
  METHODS
  Between July 1997 and April 2002, 736 consecutive patients who underwent isolated CABG were retrospectively reviewed. The OPCAB group (Group I) comprised 357 patients (49%), and the on-pump CABG group (Group II) 379 patients (51%). Their preoperative, intraoperative, and follow-up data were analyzed.
  
  
  RESULTS
  The mean number of distal anastomoses and the early graft patency were not greatly different between the two groups. The actuarial survival rate at 3 years was not significantly different between Group I (98.3%) and Group II (98.2%) (p = 0.71). The frequency of cardiac events was 4.2%/patient-year in Group I and 2.6%/patient-year in Group II (p = 0.12). The actuarial event free rates were not different between the two groups (p = 0.61). The cardiac event free rates at 3 years were significantly (p = 0.011) higher in patients with complete revascularization (96.7%) than without complete revascularization in Group I (69.2%) and in Group II (92.7% versus 85.9%, p = 0.026).
  
  
  CONCLUSIONS
  Midterm clinical outcome in OPCAB is as good as conventional on-pump CABG. Incomplete revascularization caused cardiac events more frequently than complete revascularization both in OPCAB and on-pump CABG in the intermediate follow-up.
authors.affiliation: Department of Cardiovascular Surgery, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Ishida
authors.forename: Junjiro
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Tagusari
authors.forename: Ko
authors.initials: K
authors.lastname: Bando
authors.forename: Kazuo
authors.initials: K
authors.lastname: Niwaya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakajima
authors.forename: Satsuki
authors.initials: S
authors.lastname: Fukushima
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kitamura
mesh_terms: D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome