title: Off pump coronary artery bypass grafting - midterm results.
abstract: OBJECTIVE
  Off pump coronary artery bypass (OPCAB) grafting is still discussed controversially in the cardiac surgical community. Early perioperative results are encouraging. Only few reports have focused on mid-term recurrence of angina and freedoms from death or re-intervention. -
  
  
  METHODS
  107 OPCAB patients (mean age 63 +/- 1 years, 77 male, log EuroScore 5.6 +/- 0.7, number of distal anastomoses 2.0 +/- 0.1), operated on between January 1999 and December 2003, were systematically followed up comparing pre- and post-op NYHA- and CCS-classifications and assessing freedom from death and re-intervention. 52 of 107 patients underwent postoperative angiography or multi-slice computed tomography (MSCT); 6 of the latter 52 patients were symptomatic, 3 with unstable angina, the others underwent follow-up studies having given their informed consent. -
  
  
  RESULTS
  The 30 day mortality was 2%. Freedom from death or re-intervention at 5.5 years was 91% and 80%, respectively. Only three patients required re-intervention in an OPCAB-related vessel. CCS classification was 2.8 +/- 0.1 before surgery and 1.8 +/- 0.2 (p<0.01) at follow-up (3.3 +/- 0.3 years). NYHA classification was 2.7 +/- 0.1 and 2.2 +/- 0.1 (p<0.01), respectively. Out of 107 patients, 52 underwent coronary angiography or MSCT (6 for cardiac symptoms) at a mean follow-up of 2.2 +/- 0.3 years. Left internal thoracic artery was patent in 91%, venous graft patency rate was 83%. -
  
  
  CONCLUSIONS
  In this small but consecutive OPCAB population with a considerable perioperative risk according to the EuroScore, freedom from death and re-intervention at 5.5 years is acceptable and graft patency rate at 2.2 +/- 0.3 years is in the expected range. Significant reduction in both CCS and NYHA classification indicate sustained clinical improvement at mid-term.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery,University Duisburg-Essen, West German Heart Center Essen, Germany. parwis.massoudy@uni-essen.de
authors.forename: P
authors.initials: P
authors.lastname: Massoudy
authors.forename: M
authors.initials: M
authors.lastname: Thielmann
authors.forename: P
authors.initials: P
authors.lastname: Kienbaum
authors.forename: H
authors.initials: H
authors.lastname: Kuehl
authors.forename: I
authors.initials: I
authors.lastname: Aleksic
authors.forename: R
authors.initials: R
authors.lastname: Erbel
authors.forename: H
authors.initials: H
authors.lastname: Jakob
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome