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

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

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.

Author Information

From the Departments of *Cardiac Surgery, and †Quality and Safety, Harefield Hospital, London, UK.

Accepted for publication December 12, 2013.

Presented at the Annual Scientific Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery, June 12–15, 2013, Prague, Czech Republic.

Disclosure: The authors declare no conflicts of interest.

Address correspondence and reprint requests to Shahzad G. Raja, FRCS(C-Th), Department of Cardiac Surgery, Harefield Hospital, Hill End Rd, UB9 6JH Harefield, London, UK. E-mail: drrajashahzad@hotmail.com.

©2014 by the International Society for Minimally Invasive Cardiothoracic Surgery