• Coronary artery disease · Dec 2013

    Comparative Study

    Quality of life 12 years after on-pump and off-pump coronary artery bypass grafting.

    • Otso Järvinen, Matti Hokkanen, and Heini Huhtala.
    • aHeart Center, Tampere University Hospital bSchool of Medicine cSchool of Health Sciences, University of Tampere, Tampere, Finland.
    • Coron. Artery Dis. 2013 Dec 1; 24 (8): 663-8.

    ObjectiveTo assess whether the use of either the on-pump or the off-pump method affects changes in health-related quality of life (QOL) in the long term after coronary artery bypass graft (CABG) surgery.MethodsFour hundred and fifty-two (89.0%) of the 508 patients in a single institution were operated on-pump and 56 (11.0%) were operated off-pump. The RAND-36 Health Survey (RAND-36) was used as an indicator of QOL. Assessments were performed preoperatively and repeated 1 year and 12 years later. Symptomatic status was estimated according to New York Heart Association class.ResultsAfter 1 year, on-pump patients improved significantly (P<0.001) in all eight RAND-36 dimensions. Also, in off-pump patients, positive changes were observed in all RAND-36 dimensions and these changes were statistically significant (P<0.05) in six dimensions. Despite an ongoing decrease in QOL over the 12-year follow-up, on-pump patients still maintained a significant (P<0.05) improvement in all and off-pump patients in seven out of eight RAND-36 dimensions. A highly significant (P<0.001) pattern of change after 1 year was observed in the RAND-36 Mental Component Summary and Physical Component Summary scores in both operative groups, and despite the general declining trend, significant improvement was maintained during the 12-year follow-up time. Both groups showed almost identical relief from anginal symptoms at 12 years.ConclusionA majority of patients experience significant improvement in health-related QOL in the long term after CABG. Cardiopulmonary bypass has no impact on patients' subsequent health-related QOL.

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