title: [Off-pump coronary revascularization. Late survival].
abstract: Although randomized clinical trials have compared the short-term results of coronary revascularization with on-pump vs. off-pump, the long-term survival effect of off-pump coronary surgery has not been analyzed. The aim of this study was to compare the long-term survival of patients with coronary surgery with off-pump technique. All patients that underwent coronary revascularization from November 1996 to March 2015 were included (n = 4687). We analyzed the long-term survival and the incidence of cardiac events between patients who received off-pump coronary revascularization (n = 3402) against those revascularized with on-pump technique (n = 1285). The primary endpoint was defined as death from any cause. To reduce potential biases, risk-adjusted analysis was performed (propensity score). In-hospital mortality and during follow-up (10 years) for both groups were analyzed. The overall hospital mortality was 3.1%. A statistically significant difference between groups in favor of off-pump surgery was observed (2.3% vs. 5.2%, p < 0.0001). In the survival analysis, off-pump surgery proved to have similar long-term survival as on-pump surgery (off-pump vs. on-pump: 77.9% ± 1.2% vs. 80.2% ± 1.3%, p log rank = 0.361); even in the adjusted survival analysis (84.2% ± 2.9% vs. 80.3% ± 2.4%, p = 0.169). In conclusion, off-pump coronary surgery was associated with lower in-hospital mortality; and it was not associated with increased long-term survival compared with on-pump surgery.
authors.affiliation: Departamento de Cirugía Cardíaca, Instituto Cardiovascular de Buenos Aires, Argentina. E-mail: jce.cirugia@gmail.com.ar.
authors.forename: Juan
authors.initials: J
authors.lastname: Espinoza
authors.affiliation: Departamento de Cirugía Cardíaca, Instituto Cardiovascular de Buenos Aires, Argentina.
authors.forename: Mariano
authors.initials: M
authors.lastname: Camporrontondo
authors.affiliation: Departamento de Cirugía Cardíaca, Instituto Cardiovascular de Buenos Aires, Argentina.
authors.forename: Mariano
authors.initials: M
authors.lastname: Vrancic
authors.affiliation: Departamento de Cirugía Cardíaca, Instituto Cardiovascular de Buenos Aires, Argentina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Piccinini
authors.affiliation: Departamento de Cirugía Cardíaca, Instituto Cardiovascular de Buenos Aires, Argentina.
authors.forename: Juan
authors.initials: J
authors.lastname: Camou
authors.affiliation: Departamento de Cirugía Cardíaca, Instituto Cardiovascular de Buenos Aires, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Navia
mesh_terms: D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality; D047549:Coronary Artery Bypass, Off-Pump / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: cardiac surgical procedures; coronary artery disease; extracorporeal circulation