Off-pump coronary artery bypass grafting through sternotomy: for whom?

Abstract

Though every patient must be dealt with on an individual basis, it would appear that almost any patient is a candidate for off-pump coronary artery bypass and that, given time and an appropriate desire, most any surgeon can perform the procedure.

Current Practice and Outcomes of Off-pump Multivessel Coronary Artery Bypass

“…6,20 OPCAB also improved mortality, morbidity, and resource utilization compared to on-pump CABG in high-risk patients. 6,20 Our results are consistent with these studies. Our volume of OPCAB reached a plateau over these 5 years.…”

“…20 In recent years, OPCAB has demonstrated better shortterm outcomes in terms of atrial fibrillation, blood transfusion, and length of hospital stay in mixed-risk patient populations. 6,20 OPCAB also improved mortality, morbidity, and resource utilization compared to on-pump CABG in high-risk patients. 6,20 Our results are consistent with these studies.…”

“…[1][2][3] Although many studies have compared outcomes of off-pump coronary artery bypass (OPCAB) with on-pump CABG, no definitive conclusion has been reached regarding the benefits of OPCAB vs. on-pump CABG. [4][5][6][7][8] Graft patency and incomplete revascularization have been the major concerns with the off-pump procedure. We report our experience of multivessel CABG in a recent 5-year period.…”

Racial Disparity Persists After On-Pump and Off-Pump Coronary Artery Bypass Grafting

“…10 OPCAB has been shown to be beneficial for patients at increased risk of stroke, diabetic patients, and women. [11][12][13][14][15] In particular, we have previously demonstrated a significant early mortality and morbidity advantages for women and equal 10-year survival compared with men. 12 Specifically, among OPCAB patients, we have previously reported the mitigation of adverse events and equalization of outcomes in women compared with men.…”