title: Off-pump Coronary Bypass Surgery in Patients With Low Ejection Fraction: Is There a Long-Term Survival Advantage?
abstract: OBJECTIVE
  : Long-term survival after off-pump surgery in patients with low ejection fraction was investigated.
  
  
  METHODS
  : Three hundred forty-six patients with ejection fraction 30% or less with isolated off-pump coronary artery bypass surgery (OPCAB) were compared with a propensity matched historical group operated on-pump (ONCAB) and with data from literature after percutaneous coronary intervention and OPCAB surgery.
  
  
  RESULTS
  : The lower invasiveness of OPCAB contributed to a significantly better 30-day survival, shorter postoperative length of stay, and fewer in-hospital complications. Incomplete revascularization of the posterior and lateral territories of the heart correlated with higher 1-year mortality. The probability of survival for 8 years after OPCAB was 50.1% (n = 76) versus 49.7% (n = 82) for ONCAB without comparable data from literature for OPCAB or percutaneous coronary intervention in these high-risk patients.
  
  
  CONCLUSIONS
  : OPCAB surgery in patients with low ejection fraction is a viable alternative but so far without demonstrable long-term survival advantage to ONCAB.
authors.affiliation: From the *Department of Cardiothoracic Surgery, Lenox Hill Hospital, New York, NY USA; †Department of Cardiac Surgery, Zentralklinik Bad Berka, Bad Berka, Germany; and ‡Department of Research, Lenox Hill Hospital, New York, NY USA.
authors.forename: Hagen
authors.initials: H
authors.lastname: Gorki
authors.forename: Nirav C
authors.initials: NC
authors.lastname: Patel
authors.forename: Georgia
authors.initials: G
authors.lastname: Panagopoulos
authors.forename: Joan
authors.initials: J
authors.lastname: Jennings
authors.forename: Lognathen
authors.initials: L
authors.lastname: Balacumaraswami
authors.forename: Konstadinos
authors.initials: K
authors.lastname: Plestis
authors.forename: Valavanur A
authors.initials: VA
authors.lastname: Subramanian