Graft patency after off-pump versus on-pump coronary artery surgery in high-risk patients.
OBJECTIVE
To compare angiographic graft patency in high-risk patients randomly allocated to off-pump vs. on-pump coronary artery bypass grafting (CABG).


METHODS
From a randomised, single-centre clinical trial including patients undergoing isolated first-time coronary bypass surgery a subgroup of patients were scheduled to 1-year coronary angiographic follow-up. Patients had 3-vessel disease and a EuroSCORE > or =5. We evaluated graft patency using a patency index (percentage of patent grafts out of the total number of grafts in each patient).


RESULTS
One-year angiography was performed in 34 patients undergoing off-pump surgery and 35 patients undergoing on-pump surgery. The mean number of distal anastomoses was 3.38+/-0.65 in the off-pump group versus 3.46+/-0.61 in the on-pump group (NS). The number of patients without graft failure was 22 in the off-pump group and 24 in the on-pump group (NS). The overall patency index was 85% in the off-pump group versus 87% in the on-pump group with a mean difference of -2.1%, 95% confidence interval -12.9 to 8.7 (NS).


CONCLUSIONS
In patients with 3-vessel disease and a high-risk profile we found no statistically significant difference in graft patency between off-pump and on-pump CABG at 1-year coronary angiographic follow-up.
Department of Cardio-Thoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark. chm@ctu.rh.dk
Christian H
CH
Møller
Mario J
MJ
Perko
Jens T
JT
Lund
Lars W
LW
Andersen
Henning
H
Kelbaek
Jan K
JK
Madsen
Christian
C
Gluud
Daniel A
DA
Steinbrüchel
D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency