Early and midterm outcome after off-pump and on-pump surgery in beating heart against cardioplegic arrest studies (BHACAS 1 and 2): a pooled analysis of two randomized controlled trials

Angelini, Gianni D; Taylor, Frances C.; Reeves, Barnaby C; Ascione, Raffaele

doi:10.1016/s1062-1458(02)00827-9

Cited by 55 publications

(105 citation statements)

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“…Although 3 published randomized series of OPCAB grafting versus on-pump CABG have shown no clear benefit from the standpoint of operative mortality and neurologic complication, they are all underpowered, even in a meta-analysis, to demonstrate benefit. 18,29,30 Significant benefit has been shown, however, in some other end points, such as postoperative atrial fibrillation and need for transfusion. Retrospective analysis of large databases have shown a statistically significant benefit in operative mortality with the use of OPCAB.…”

Section: Discussionmentioning

confidence: 99%

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in a Matched Sample of Women

et al. 2004

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Background-Women have consistently higher mortality and morbidity than men after coronary artery bypass grafting (CABG). Whether elimination of cardiopulmonary bypass and performance of coronary artery bypass grafting off-pump (OPCAB) have a beneficial effect specifically in women has not been defined. Methods and Results-From January 1998 through March 2002, 21 902 consecutive female patients at 82 hospitals underwent isolated CABG, as reported in an administrative database. Propensity score computer matching was performed based on 13 variables representing patient characteristics and preoperative risk factors to correct for and minimize selection bias. A total of 7376 (3688 pairs) women undergoing CABG surgery were able to be successfully matched. In a propensity score computer-matched cohort, multivariate logistic regression (odds ratio) revealed that women undergoing on-pump surgery had a 73.3% higher mortality (Pϭ0.002) and a 47.2% higher risk of bleeding complications (Pϭ0.019). Conclusions-In a retrospective analysis of women undergoing CABG, computer-matched to minimize selection bias, off-pump surgery led to decreased mortality and morbidity including bleeding complications.

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Section: Discussionmentioning

confidence: 99%

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in a Matched Sample of Women

et al. 2004

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“…Controversial results from these studies led to different opinions regarding the routine application of off pump coronary surgery [42][43][44][45][46][47][48]. This seemed to be mostly due to improper training, case selection and excessive enthusiasm, as surgeons attempted to apply this alternative of revascularization to all patients.…”

Section: IVmentioning

confidence: 99%

Myocardial revascularization without cardiopulmonary bypass

Buffolo¹,

Lima²,

Salerno³

2011

Rev Bras Cir Cardiovasc

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“…Among other things, it was expected to reduce operative trauma [1][2] , incidence of serious post-operative complications 3 and thus decrease mortality. The results from patient surgery without the use of cardiopulmonary bypass (CPB), in a group of consecutive non-selected patients, have been promising 4 . However, several randomized trials comparing off-pump and on-pump techniques conducted in recent years have failed to demonstrate any significant differences in mortality, stroke, myocardial infarction, or new renal failure.…”

Section: Introductionmentioning

confidence: 99%

Off-pump versus on-pump coronary artery bypass grafting surgery in high-risk patients: PRAGUE-6 trial at 30 days and 1 year

Hlavicka¹,

Straka²,

Jelínek³

et al. 2016

BIOMED PAP

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Aims. Off-pump coronary artery bypass graft surgery (OPCAB) is an established alternative to on-pump surgical revascularization. Previous studies in patients with low or intermediate risk showed no significant differences between off-pump and on-pump surgical revascularization. The aim of this study was to compare the two techniques in patients with high operative risk. Methods. PRAGUE-6 is a prospective randomized single-center study of 206 patients, with an additive EuroSCORE ≥ 6, scheduled for isolated coronary surgery: Group A -on-pump (n = 108) versus Group B -off-pump (n = 98). The primary outcome was a combined endpoint of all-cause deaths, stroke, myocardial infarction, or renal failure requiring new hemodialysis, within 30 days and 1 year after randomization. All data were analyzed using the "intention-to-treat" principle. Results. Early postoperative myocardial infarction was detected in 12.1% (A) vs. 4.1% (B) of patients (P = 0.048, hazard ratio 0.32, 95% CI 0.11-0.99). There was a significantly higher incidence of primary combined end-point in group A (20.6% vs. 9.2%, P = 0.028, HR 0.41, 95% CI 0.19-0.91) in the first 30 days, but not after 1 year (30.8% vs. 21.4%, P = 0.117, HR 0.65, CI 0.37-1.12). Conclusion. Off-pump surgical revascularization in patients with high operative risks can significantly reduce the incidence of major postoperative complications during the first 30 days. There was no statistically significant difference in the incidence of these complications after 1 year.

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Early and midterm outcome after off-pump and on-pump surgery in beating heart against cardioplegic arrest studies (BHACAS 1 and 2): a pooled analysis of two randomized controlled trials

Cited by 55 publications

References 0 publications

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in a Matched Sample of Women

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in a Matched Sample of Women

Myocardial revascularization without cardiopulmonary bypass

Off-pump versus on-pump coronary artery bypass grafting surgery in high-risk patients: PRAGUE-6 trial at 30 days and 1 year

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