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Totally arterial off-pump vs. on-pump coronary revascularization: comparison of early outcome

Clinic for Cardiovascular Surgery, Swiss Cardiovascular Center Bern, University Hospital, CH-3010 Bern, Switzerland

^* Corresponding author. Tel.: +41-31-632-9268; fax: +41-31-632-2919
pascal.berdat{at}insel.ch

Our objective was to assess differences in early outcome after completely arterial myocardial revascularization with (on-pump coronary artery bypass grafting or ONCAB) or without cardiopulmonary bypass (off-pump coronary artery bypass grafting or OPCAB). Fifty-eight OPCAB and 91 ONCAB patients receiving exclusively arterial grafts were analyzed. OPCAB patients had more single-vessel less triple-vessel or left main disease higher angina class more unstable angina and previous percutanueous transluminal coronary angioplasty (PTCA; ), but similar EuroScores ONCAB was associated with longer operation time and more anastomoses/patient Internal thoracic artery (ITA) use was identical, whereas single left ITA use and left ITA jump anastomoses were more frequent in OPCAB. Radial artery (RA) use and RA jump anastomoses were more frequent in ONCAB. Complication rates were similar concerning mortality, arrhythmias, cerebro-vascular accidents (CVA), and renal failure with shorter ventilatory support and a trend towards less perioperative myocardial infarction (PMI) and low output and more respiratory complications after OPCAB. Arterial OPCAB patients have less extensive CAD, but more severe symptoms. Early outcome is similar concerning mortality, arrhythmias, CVA, renal failure, or intensive care unit and hospital stay, but with shorter ventilatory support and a trend towards lower PMI and low output, and higher respiratory complication rates after OPCAB.

Key Words: Off-pump coronary artery bypass surgery; Cardiopulmonary bypass; Outcome; Arteries