Clinical and radiologic outcome of off-pump coronary surgery at 12 months follow-up: a prospective randomized trial

Ann Thorac Surg. 2006 Jun;81(6):2089-95. doi: 10.1016/j.athoracsur.2005.12.003.

Abstract

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Angina Pectoris / epidemiology
  • Coronary Angiography*
  • Coronary Artery Bypass, Off-Pump / statistics & numerical data*
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / epidemiology*
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / epidemiology
  • Humans
  • Internal Mammary-Coronary Artery Anastomosis
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myocardium / pathology
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Saphenous Vein / transplantation
  • Single-Blind Method
  • Treatment Outcome