title: Off-pump no-touch technique: 3-year results compared with the SYNTAX trial.
abstract: OBJECTIVE
  A 3-year follow-up of a retrospective, single-centre clinical study of OPCAB (off-pump coronary artery bypass) no-touch technique with arterial composite grafts and an indirect comparison with clinical outcomes of the 3-year follow-up of the SYNTAX trial.
  
  
  METHODS
  A total of 400 consecutive patients ('all-comers') who underwent OPCAB no-touch coronary surgery. Primary endpoint was 3-year MACCE (major adverse cardiovascular and cerebrovascular events). These results were compared with the randomized arms of the SYNTAX trial.
  
  
  RESULTS
  The observed 3-year survival was 82.2%. The cumulative 3-year freedom from MACCE was 89.7%. The percentage of MACCE was significantly lower (P < 0.001) in the OPCAB no-touch group (10.3%) compared with both arms of the SYNTAX trial (20.2 and 28.0%, respectively). Repeat revascularization in the OPCAB no-touch group (4.3%) was significantly lower (P < 0.001) compared with both arms of the SYNTAX trial (10.7 and 19.7%, respectively). The percentage of stroke was significantly lower (P = 0.032) in the OPCAB no-touch group compared with the CABG arm in the SYNTAX trial (1.3 vs 3.4%). There was no significant difference of stroke rate between the OPCAB no-touch group and the PCI arm of the SYNTAX trial (1.3 vs 2%, P = 0.347).
  
  
  CONCLUSIONS
  The results at the 3-year follow-up showed the safety and efficacy of OPCAB no-touch technique. The OPCAB no-touch technique may improve patients' outcome by minimizing the morbidity and the neurological complications. Prospective controlled trials are needed to confirm these results.
authors: Thoraxcenter, University Medical Center, Groningen, Netherlands s.c.arrigoni@umcg.nl.
authors: Sara C
authors: SC
authors: Arrigoni
authors: Thoraxcenter Twente, Enschede, Netherlands.
authors: Gianclaudio
authors: G
authors: Mecozzi
authors: Thoraxcenter Twente, Enschede, Netherlands.
authors: Jan G
authors: JG
authors: Grandjean
authors: Department of Epidemiology, University Medical Center, Groningen, Netherlands.
authors: Jan L
authors: JL
authors: Hillege
authors: Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands.
authors: Arie P
authors: AP
authors: Kappetein
authors: Thoraxcenter, University Medical Center, Groningen, Netherlands.
authors: Massimo A
authors: MA
authors: Mariani
mesh_terms: D000368:Aged; D002423:Cause of Death; D017023:Coronary Angiography / Q000379:methods; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods / Q000401:mortality*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D013997:Time Factors; D014110:Touch
keywords: Comparative study; Coronary artery anastomosis; Coronary artery bypass; Internal mammary; Off-pump; Radial artery