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Ann Thorac Surg 2006;81:2089-2095
© 2006 The Society of Thoracic Surgeons

Original article: Cardiovascular

Clinical and Radiologic Outcome of Off-Pump Coronary Surgery at 12 Months Follow-Up: A Prospective Randomized Trial

Per Snorre Lingaas, MD a , * , Per Kristian Hol, MD b , Runar Lundblad, MD, PhD a , Kjell Arne Rein, MD, PhD a , Lars Mathisen, MS a , Hans-Jørgen Smith, MD, PhD c , Rune Andersen, MD c , Erik Thaulow, MD, PhD d , Tor Inge Tønnesen, MD, PhD e , Jan Ludvig Svennevig, MD, PhD a , Sigurd Nitter Hauge, MD, PhD f , Per Morten Fredriksen, PT, PhD g , Marit Andersen, MS h , Erik Fosse, MD, PhD b

a Department of Thoracic and Cardiovascular Surgery, Oslo, Norway
b The Interventional Centre, Oslo, Norway
c Department of Radiology, Oslo, Norway
d Department of Pediatrics, Oslo, Norway
e Department of Anesthesiology, Oslo, Norway
f Department of Cardiology, Oslo, Norway
g Department of Physiotherapy, Oslo, Norway
h Department of Surgery, Rikshospitalet University Hospital, Oslo, Norway

Accepted for publication December 1, 2005.

* Address correspondence to Dr Lingaas, Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, N-0027 Norway (Email: per.snorre.lingaas{at}rikshospitalet.no).

BACKGROUND: After more than a decade of experience with off-pump coronary bypass surgery, still no consensus exists concerning its benefit on clinical outcome compared to the on-pump technique. In this 12-month follow-up, we compare off-pump and on-pump surgery on the appearance of graft patency, myocardial function, and clinical outcome.

METHODS: One hundred twenty patients were randomized to off-pump or on-pump coronary surgery. Angiography was performed intraoperatively, at 3 and 12 months. Global myocardial function was estimated by magnetic resonance imaging (MRI) preoperatively and 12 months postoperatively, as well as functional class and stress testing.

RESULTS: After 12 months internal mammary artery patency was 94% in the off-pump group and 96% in the on-pump group. Vein graft patency was 80% and 87%, respectively. No statistically significant difference between the two groups existed. There were no differences in exercise capacity improvement and attenuation of symptoms between the groups.

CONCLUSIONS: At 12-months follow-up, off-pump coronary bypass surgery provided the same angiographic graft patency as the on-pump technique. Improvement in functional class and exercise capacity was the same in both groups.


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