TY - JOUR
T1 - Off-pump coronary bypass surgery in patients with low ejection fraction
T2 - Is there a long-term survival advantage?
AU - Gorki, Hagen
AU - Patel, Nirav C.
AU - Panagopoulos, Georgia
AU - Jennings, Joan
AU - Balacumaraswami, Lognathen
AU - Plestis, Konstadinos
AU - Subramanian, Valavanur A.
PY - 2010
Y1 - 2010
N2 - Objective: Long-term survival after off-pump surgery in patients with low ejection fraction was investigated. Methods: Three hundred forty-six patients with ejection fraction 30% or less with isolated off-pump coronary artery bypass surgery (OPCAB) were compared with a propensity matched historical group operated on-pump (ONCAB) and with data from literature after percutaneous coronary intervention and OPCAB surgery. Results: The lower invasiveness of OPCAB contributed to a significantly better 30-day survival, shorter postoperative length of stay, and fewer in-hospital complications. Incomplete revascularization of the posterior and lateral territories of the heart correlated with higher 1-year mortality. The probability of survival for 8 years after OPCAB was 50.1% (n = 76) versus 49.7% (n = 82) for ONCAB without comparable data from literature for OPCAB or percutaneous coronary intervention in these high-risk patients. Conclusions: OPCAB surgery in patients with low ejection fraction is a viable alternative but so far without demonstrable long-term survival advantage to ONCAB.
AB - Objective: Long-term survival after off-pump surgery in patients with low ejection fraction was investigated. Methods: Three hundred forty-six patients with ejection fraction 30% or less with isolated off-pump coronary artery bypass surgery (OPCAB) were compared with a propensity matched historical group operated on-pump (ONCAB) and with data from literature after percutaneous coronary intervention and OPCAB surgery. Results: The lower invasiveness of OPCAB contributed to a significantly better 30-day survival, shorter postoperative length of stay, and fewer in-hospital complications. Incomplete revascularization of the posterior and lateral territories of the heart correlated with higher 1-year mortality. The probability of survival for 8 years after OPCAB was 50.1% (n = 76) versus 49.7% (n = 82) for ONCAB without comparable data from literature for OPCAB or percutaneous coronary intervention in these high-risk patients. Conclusions: OPCAB surgery in patients with low ejection fraction is a viable alternative but so far without demonstrable long-term survival advantage to ONCAB.
UR - http://www.scopus.com/inward/record.url?scp=76449090270&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76449090270&partnerID=8YFLogxK
U2 - 10.1097/IMI.0b013e3181cf8228
DO - 10.1097/IMI.0b013e3181cf8228
M3 - Article
C2 - 22437274
AN - SCOPUS:76449090270
SN - 1556-9845
VL - 5
SP - 33
EP - 41
JO - Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
JF - Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
IS - 1
ER -