title: Off-pump coronary artery bypass and avoidance of hypothermic cardiac arrest improves early left ventricular function in patients with systolic dysfunction.
abstract: OBJECTIVE
  Off-pump coronary artery bypass surgery (OPCAB) and beating-heart coronary artery bypass grafting (BH-CAB) performed with cardiopulmonary bypass support are used with increasing frequency in the treatment of coronary artery occlusive disease. The utility of OPCAB and BH-CAB in treating high-risk patients has been studied, but the effects of these procedures on ventricular function have not been thoroughly investigated.
  
  
  METHODS
  Data were collected from a database encompassing all patients who underwent isolated coronary revascularization performed by a single surgeon between August 2002 and March 2007. All procedures (n = 507) began as OPCAB operations, but 99 were converted to BH-CAB during surgery. Each patient's ejection fraction (EF) was measured preoperatively and postoperatively (median, 5.0 days after surgery).
  
  
  RESULTS
  We found that although the BH-CAB patients tended to be in worse health and to have a lower preoperative EF than the OPCAB patients, both groups of patients had similar improvements in postoperative EF (6.8% vs 5.4%; p = 0.65). In addition, multivariable linear regression showed that a lower preoperative EF, age ≥ 70 years, and cardiomegaly predicted less postoperative EF improvement after coronary revascularization by either OPCAB or BH-CAB.
  
  
  CONCLUSIONS
  Both OPCAB and BH-CAB procedures produce significant and similar short-term improvement in EF in patients with coronary disease. This change in EF may account for the subjective clinical improvements seen early after both procedures.
authors.affiliation: Texas Heart Institute at St Luke's Episcopal Hospital, Houston, TX, USA. George.v.letsou@uth.tmc.edu
authors.forename: George V
authors.initials: GV
authors.lastname: Letsou
authors.forename: Ying Xing
authors.initials: YX
authors.lastname: Wu
authors.forename: Gary
authors.initials: G
authors.lastname: Grunkemeier
authors.forename: Murtuza M
authors.initials: MM
authors.lastname: Rampurwala
authors.forename: Larry
authors.initials: L
authors.lastname: Kaiser
authors.forename: Abhijit L
authors.initials: AL
authors.lastname: Salaskar
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D000075202:Contraindications; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D052279:Creatine Kinase, MB Form / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers; D052279:Creatine Kinase, MB Form