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Innovations: Technology & Techniques in Cardiothoracic & Vascular Surgery:
doi: 10.1097/IMI.0000000000000042
Original Articles

Long-Term Follow-up of Off-Pump and On-Pump Coronary Artery Bypass Grafting

Raja, Shahzad G. FRCS(C-Th)*; Benedetto, Umberto MD, PhD*; Chudasama, Dimple BSc; Daley, Siobhan MSc; Husain, Mubassher MRCS*; Amrani, Mohamed MD, PhD*; for the Harefield Cardiac Outcomes Research Group

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Objective: Despite increasing recognition of the benefits of off-pump coronary artery bypass grafting (CABG), concerns persist regarding its impact on long-term mortality and freedom from reintervention. In this study, we assessed the impact of off-pump CABG on long-term outcomes.

Methods: From January 2002 to December 2002, a total of 307 consecutive patients who underwent isolated multivessel off-pump CABG at our institution were compared with a control group of 397 patients who underwent multivessel on-pump CABG during the same period. Perioperative data were prospectively collected and compared. In addition, univariate and risk-adjusted comparisons between the two groups were performed at 10 years.

Results: After adjusting for clinical covariates, off-pump CABG did not emerge as a significant independent predictor of long-term mortality [hazard ratio (HR), 0.91; 95% confidence interval (CI), 0.70–1.12], readmission to hospital for cardiac cause (HR, 0.96; 95% CI, 0.78–1.10), or the need for reintervention (HR, 0.93; 95% CI, 0.87–1.05).

Conclusions: At long-term follow-up, off-pump CABG remains a safe and effective myocardial revascularization strategy with no adverse impact on survival or freedom from reintervention.

©2014 by the International Society for Minimally Invasive Cardiothoracic Surgery


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