10-year follow-up of off-pump multivessel coronary artery bypass grafting.
On-pump total arterial grafting is associated with improved long-term outcomes compared to conventional grafting using left internal thoracic artery and saphenous vein grafts, but there are no data to confirm the same for off-pump total arterial grafting. We assessed the impact of off-pump total arterial grafting on medium-term outcomes. From September 1998 to September 2008, 580 consecutive patients who had off-pump multivessel arterial grafting only were compared with a control group of 806 patients undergoing off-pump coronary artery bypass with internal thoracic artery and saphenous vein grafts, performed by the same surgeon. Perioperative data were collected prospectively. Medium-term univariate and risk-adjusted comparisons between the 2 groups were carried out. After adjusting for clinical covariates, total arterial grafting did not emerge as a significant independent predictor of medium-term mortality, readmission to hospital, or the composite outcome of death and readmission. At medium-term follow-up, off-pump total arterial grafting, despite being a safe and effective myocardial revascularization strategy, offered no mortality or morbidity benefits.
Department of Cardiac Surgery, Harefield Hospital, Hill End Road, Harefield, UK. drrajashahzad@hotmail.com
Shahzad G
SG
Raja
Manoraj
M
Navaratnarajah
C Saifuddin
CS
Kitchlu
Shane
S
George
Charles D
CD
Ilsley
Mohamed
M
Amrani
D000368:Aged; D016022:Case-Control Studies; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality; D004739:England; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation*; D008875:Middle Aged; D010359:Patient Readmission; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome