• Ann Lycops, Carolien Wever, Jos Vandekerkhof, Urbain Mees, and Marc Hendrikx.
• Dept. of Cardiothoracic and Vascular Surgery, Virga Jesse Hospital, Hasselt, Belgium.
• Acta Cardiol. 2005 Jun 1; 60 (3): 311-7.

ObjectiveEarly survival in off-pump coronary artery bypass (OPCAB) patients is reported to be as good as that of conventional coronary artery bypass grafting (CABG). However, it remains unknown whether midterm cardiac outcome after off-pump surgery is similar to that for the on-pump procedure.Methods And ResultsOne hundred OPCAB patients (67.8 (9.3) y) were compared to a case-matched contemporary group of CABG patients (69.4 (8.8) y). In-hospital and midterm outcome data are presented. Follow-up was 100% complete. The mean number of distal anastomoses per patient was 1.9 (0.8) and 2.4 (1.0) in the OPCAB and CABG group, respectively. Grafting according to treatment plan was 100% in both groups. Peak creatine kinase muscle-brain and cardiac troponin I (cTnI) release were similar in the overall groups, but the cTnI release in the 25 most recently operated patients was significantly lower in the OPCAB group (4.8 (9.1) ng/ml vs. 14.0 (20.5) ng/ml, p = 0.04). Duration of mechanical ventilation, ICU stay and hospital stay were shorter in the OPCAB group. The incidence of atrial fibrillation was similar. There were no differences in in-hospital complications. The actuarial survival at 1, 3 and 5 years was 88% (C.I. 81.6 to 94.3), 78% (C.I. 66.1 to 90.2) and 78% (C.I. 66.1 to 90.2) in the OPCAB and 90% (C.I. 84.0 to 95.9), 84% (C.I. 74.6 to 92.5) and 68% (C.I. 44.7 to 90.6) in the CABG group (log rank p-value = 0.96). Event-free survival at 1, 3, 5 years was 85% (C.I. 77.8 to 91.9), 71 % (C.I. 57.4 to 84.2) and 71 % (C.I. 57.4 to 84.2) in the OPCAB and 85% (C.I. 77.8 to 91.9), 72% (C.I. 61.1 to 82.7) and 58% (C.I. 37.2 to 78.8) in the CABG group (log rank p-value = 0.63). Recurrence of angina (3%) and need for reintervention (2%) in the OPCAB group were low.ConclusionsOPCAB surgery is a safe and reproducible technique, yielding short-and midterm outcomes comparable to conventional CABG.

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