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Ann Thorac Surg 2001;72:1282-1289
© 2001 The Society of Thoracic Surgeons
a University of Colorado Health Sciences Center, Denver, Colorado, USA
b Denver Department of Veterans Affairs Medical Center, Denver, Colorado, USA
c Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA
Address reprint requests to Dr Cleveland, Division of Cardiothoracic Surgery, University of Colorado Health Sciences Center, Box C-310, 4200 E Ninth Ave, Denver, CO 80262
e-mail: joseph.cleveland{at}uchsc.edu
Presented at the Forty-seventh Annual Meeting of the Southern Thoracic Surgical Association, Marco Island, FL, Nov 911, 2000.
Background. The purpose of this study was to determine whether coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG) decreases risk-adjusted operative death and major complications after coronary artery bypass grafting in selected patients.
Methods. Using The Society of Thoracic Surgeons (STS) National Adult Cardiac Surgery Database, procedural outcomes were compared for conventional and off-pump CABG procedures from January 1, 1998, through December 31, 1999. Mortality and major complications were examined, both as unadjusted rates and after adjusting for known base line patient risk factors.
Results. A total of 126 experienced centers performed 118,140 total CABG procedures. The number of off-pump CABG cases was 11,717 cases (9.9% of total cases). The use of an off-pump procedure was associated with a decrease in risk-adjusted operative mortality from 2.9% with conventional CABG to 2.3% in the off-pump group (p < 0.001). The use of an off-pump procedure decreased the risk-adjusted major complication rate from 14.15% with conventional CABG to 10.62% in the off-pump group (p < 0.0001). Patients receiving off-pump procedures were less likely to die (adjusted odds ratio 0.81, 95% CI 0.70 to 0.91) and less likely to have major complications (adjusted odds ratio 0.77, 95% CI 0.72 to 0.82).
Conclusions. Off-pump CABG is associated with decreased mortality and morbidity after coronary artery bypass grafting. Off-pump CABG may prove superior to conventional CABG in appropriately selected patients.
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T. Athanasiou, S. Al-Ruzzeh, P. Kumar, M.-C. Crossman, M. Amrani, J. R. Pepper, R. Del Stanbridge, R. Casula, and B. Glenville Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients Ann. Thorac. Surg., February 1, 2004; 77(2): 745 - 753. [Abstract] [Full Text] [PDF] |
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D. Taggart Off-pump surgery and cerebral injury J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 7 - 9. [Full Text] [PDF] |
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J. F. Sabik, E. H. Blackstone, B. W. Lytle, P. L. Houghtaling, A. M. Gillinov, and D. M. Cosgrove Equivalent midterm outcomes after off-pump and on-pump coronary surgery J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 142 - 148. [Abstract] [Full Text] [PDF] |
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Y. Wu, G. L. Grunkemeier, and J. R. Handy Jr Coronary artery bypass grafting: Are risk models developed from on-pump surgery valid for off-pump surgery? J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 174 - 178. [Abstract] [Full Text] [PDF] |
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V. Piacentino III, J. Jones, C. A. Fisher, A. K. Singhal, M. Macha, J. B. McClurken, and S. Furukawa Off-pump technique for insertion of a HeartMate vented electric left ventricular assist device J. Thorac. Cardiovasc. Surg., January 1, 2004; 127(1): 262 - 264. [Full Text] [PDF] |
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S. Al-Ruzzeh, T. Athanasiou, S. George, and M. Amrani Methodological approach in adopting off-pump coronary artery bypass surgery in a British cardiothoracic unit: Harefield experience Perfusion, January 1, 2004; 19(1_suppl): S61 - S66. [Abstract] [PDF] |
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H. K. Song, R. J. Petersen, E. Sharoni, R. A. Guyton, and J. D. Puskas Safe evolution towards routine off-pump coronary artery bypass: negotiating the learning curve Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 947 - 952. [Abstract] [Full Text] [PDF] |
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A. Boening, C. Friedrich, J. Hedderich, J. Schoettler, S. Fraund, and J. T. Cremer Early and medium-term results after on-pump and off-pump coronary artery surgery: a propensity score analysis Ann. Thorac. Surg., December 1, 2003; 76(6): 2000 - 2006. [Abstract] [Full Text] [PDF] |
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T. Suzuki, M. Okabe, F. Yasuda, Y. Miyake, M. Handa, and T. Nakamura Our experiences for off-pump coronary artery bypass grafting to the circumflex system Ann. Thorac. Surg., December 1, 2003; 76(6): 2013 - 2016. [Abstract] [Full Text] [PDF] |
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A. S. Michalopoulos, S. Geroulanos, and S. D. Mentzelopoulos Determinants of Candidemia and Candidemia-Related Death in Cardiothoracic ICU Patients Chest, December 1, 2003; 124(6): 2244 - 2255. [Abstract] [Full Text] [PDF] |
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J. T. Reston, S. J. Tregear, and C. M. Turkelson Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting Ann. Thorac. Surg., November 1, 2003; 76(5): 1510 - 1515. [Abstract] [Full Text] [PDF] |
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S. P. Talpahewa, R. Ascione, G. D. Angelini, and A. T. Lovell Cerebral cortical oxygenation changes during OPCAB surgery Ann. Thorac. Surg., November 1, 2003; 76(5): 1516 - 1522. [Abstract] [Full Text] [PDF] |
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K. V. Arom and F. L. Grover Adult cardiac surgery during the first 50 years of the Southern Thoracic Surgical Association Ann. Thorac. Surg., November 1, 2003; 76(90050): S17 - 46. [Abstract] [Full Text] [PDF] |
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G. D'Ancona, J. I. S. de Ibarra, R. Baillot, P. Mathieu, D. Doyle, J. Metras, D. Desaulniers, and F. Dagenais Determinants of stroke after coronary artery bypass grafting Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 552 - 556. [Abstract] [Full Text] [PDF] |
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D. L. Ngaage Off-pump coronary artery bypass grafting: the myth, the logic and the science Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 557 - 570. [Abstract] [Full Text] [PDF] |
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S. Al-Ruzzeh, G. Ambler, G. Asimakopoulos, R. Z. Omar, R. Hasan, B. Fabri, A. El-Gamel, A. DeSouza, V. Zamvar, S. Griffin, et al. Off-Pump Coronary Artery Bypass (OPCAB) Surgery Reduces Risk-Stratified Morbidity and Mortality: A United Kingdom Multi-Center Comparative Analysis of Early Clinical Outcome Circulation, September 9, 2003; 108(90101): II-1 - 8. [Abstract] [Full Text] [PDF] |
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R. J. Novick, S. A. Fox, B. B. Kiaii, L. W. Stitt, R. Rayman, K. Kodera, A. H. Menkis, and W. D. Boyd Analysis of the learning curve in telerobotic, beating heart coronary artery bypass grafting: a 90 patient experience Ann. Thorac. Surg., September 1, 2003; 76(3): 749 - 753. [Abstract] [Full Text] [PDF] |
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J Gunn and D P Taggart Revascularisation for acute coronary syndromes: PCI or CABG? Heart, September 1, 2003; 89(9): 967 - 970. [Full Text] [PDF] |
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R. J. Dabal, J. R. Goss, C. Maynard, and G. S. Aldea The effect of left internal mammary artery utilization on short-term outcomes after coronary revascularization Ann. Thorac. Surg., August 1, 2003; 76(2): 464 - 470. [Abstract] [Full Text] [PDF] |
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P. Biglioli, A. Cannata, F. Alamanni, M. Naliato, M. Porqueddu, M. Zanobini, E. Tremoli, and A. Parolari Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 260 - 269. [Abstract] [Full Text] [PDF] |
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R. B. Beauford, D. J. Goldstein, F. F. Sardari, R. Karanam, B. Luk, T. W. Prendergast, P. G. Burns, P. Garland, C. Chen, O. Patafio, et al. Multivessel off-pump revascularization in octogenarians: early and midterm outcomes Ann. Thorac. Surg., July 1, 2003; 76(1): 12 - 17. [Abstract] [Full Text] [PDF] |
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F. F. Immer, P. A. Berdat, A. S. Immer-Bansi, F. S. Eckstein, S. Muller, H. Saner, and T. P. Carrel Benefit to quality of life after Off-Pump versus On-Pump coronary bypass surgery Ann. Thorac. Surg., July 1, 2003; 76(1): 27 - 31. [Abstract] [Full Text] [PDF] |
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H. W. Donias, R. Pande, H. L. Karamanoukian, M. Gomberg-Maitland, J. L. Halperin, J. Healey, E. Fenwick, B. O'Brien, H. M. Nathoe, E. Buskens, et al. Off-Pump Coronary Bypass Surgery N. Engl. J. Med., May 8, 2003; 348(19): 1928 - 1931. [Full Text] [PDF] |
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R. Ascione and G. D. Angelini Off-pump coronary artery bypass surgery: The implications of the evidence J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 779 - 781. [Full Text] [PDF] |
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J. D. Puskas, W. H. Williams, P. G. Duke, J. R. Staples, K. E. Glas, J. J. Marshall, M. Leimbach, P. Huber, S. Garas, B. H. Sammons, et al. Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: A prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 797 - 808. [Abstract] [Full Text] [PDF] |
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S. Schroeder, N. Borger, H. Wrigge, A. Welz, C. Putensen, A. Hoeft, and F. Stuber A tumor necrosis factor gene polymorphism influences the inflammatory response after cardiac operation Ann. Thorac. Surg., February 1, 2003; 75(2): 534 - 537. [Abstract] [Full Text] [PDF] |
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V. Piacentino III, A. K. Singhal, M. Macha, J. B. McClurken, C. A. Fisher, and S. Furukawa Off-pump technique for Thoratec left ventricular assist device insertion Ann. Thorac. Surg., February 1, 2003; 75(2): 607 - 609. [Abstract] [Full Text] [PDF] |
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H. M. Nathoe, D. van Dijk, E. W.L. Jansen, W. J.L. Suyker, J. C. Diephuis, W.-J. van Boven, A. B. de la Riviere, C. Borst, C. J. Kalkman, D. E. Grobbee, et al. A Comparison of On-Pump and Off-Pump Coronary Bypass Surgery in Low-Risk Patients N. Engl. J. Med., January 30, 2003; 348(5): 394 - 402. [Abstract] [Full Text] [PDF] |
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