Off-pump versus on-pump coronary surgery: final results from a prospective randomized study Prague-4

Straka, Zbyněk; Widimský, Petr; Jirásek, K; Štros, Petr; Votava, Jan; Vanek, Tomas; Brucek, Petr; Kolesar, Miroslav; Spacek, R

doi:10.1016/j.athoracsur.2003.08.039

Cited by 175 publications

(132 citation statements)

References 15 publications

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“…[2][3][4][5][6] Among the largest trials are the Randomized On/Off Bypass (ROOBY) 7,8 trial, which enrolled 2203 patients from the Veterans Affairs medical system, and the Danish On-Pump versus Off-Pump Randomization Study (DOORS), which enrolled 900 patients. 9,10 Neither of these trials had sufficient power to accurately assess moderate but clinically important differences between the groups with respect to death, myocardial infarction, stroke, or renal failure.…”

Section: Resultsmentioning

confidence: 99%

Effects of Off-Pump and On-Pump Coronary-Artery Bypass Grafting at 1 Year

Lamy¹,

Devereaux²,

Prabhakaran³

et al. 2014

Survey of Anesthesiology

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BACKGROUND: Previously, we reported that there was no significant difference at 30 days in the rate of a primary composite outcome of death, myocardial infarction, stroke, or new renal failure requiring dialysis between patients who underwent coronary-artery bypass grafting (CABG) performed with a beating-heart technique (off-pump) and those who underwent CABG performed with cardiopulmonary bypass (on-pump). We now report results on quality of life and cognitive function and on clinical outcomes at 1 year. METHODS: We enrolled 4752 patients with coronary artery disease who were scheduled to undergo CABG and randomly assigned them to undergo the procedure off-pump or on-pump. Patients were enrolled at 79 centers in 19 countries. We assessed quality of life and cognitive function at discharge, at 30 days, and at 1 year and clinical outcomes at 1 year. RESULTS: At 1 year, there was no significant difference in the rate of the primary composite outcome between off-pump and on-pump CABG (12.1% and 13.3%, respectively; hazard ratio with off-pump CABG, 0.91; 95% confidence interval [CI], 0.77 to 1.07; P=0.24). The rate of the primary outcome was also similar in the two groups in the period between 31 days and 1 year (hazard ratio, 0.79; 95% CI, 0.55 to 1.13; P=0.19). The rate of repeat coronary revascularization at 1 year was 1.4% in the off-pump group and 0.8% in the on-pump group (hazard ratio, 1.66; 95% CI, 0.95 to 2.89; P=0.07). There were no significant differences between the two groups at 1 year in measures of quality of life or neurocognitive function. CONCLUSIONS: At 1 year after CABG, there was no significant difference between off-pump and on-pump CABG with respect to the primary composite outcome, the rate of repeat coronary revascularization, quality of life, or neurocognitive function. (Funded by the Canadian Institutes of Health Research; CORONARY ClinicalTrials.gov number, NCT00463294.).

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Section: Resultsmentioning

confidence: 99%

Effects of Off-Pump and On-Pump Coronary-Artery Bypass Grafting at 1 Year

Lamy¹,

Devereaux²,

Prabhakaran³

et al. 2014

Survey of Anesthesiology

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“…Recent meta-analyses have suggested that compared with conventional coronary artery bypass (CCAB) surgery, OPCAB surgery may significantly reduce stroke (OR of 0.38, 95% CI 0.22 to 0.65) (8), duration of ventilation (3.4 fewer hours, 95% CI 1.7 to 5.0) (9), atrial fibrillation (OR of 0.58 to 0.7, 95% CI 0.44 to 0.89) (9,10), transfusion requirements (OR of 0.43, 95% CI 0.29 to 0.65) (9) and postoperative length of stay (LOS) (one fewer day in hospital, 95% CI 0.5 to 1.5) (9). Conversely, some randomized controlled trials have been unable to show such benefits (11)(12)(13), BACKGROUND: Off-pump coronary artery bypass (OPCAB) surgery has been successfully used in diverse patient populations and has been postulated to be safer than conventional coronary artery bypass (CCAB) surgery in some high-risk patients, including the elderly. OBJECTIVE: To compare the safety of OPCAB surgery versus CCAB surgery in the octogenarian population of two large southwestern Ontario cardiac surgical units.…”

mentioning

confidence: 99%

Early outcomes of coronary artery bypass with and without cardiopulmonary bypass in octogenarians

Nagpal¹,

Bhatnagar²,

Cutrara³

et al. 2006

Canadian Journal of Cardiology

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“…Dos de los tres fallecidos correspondieron a conversiones a cirugía con bomba, Las otras complicaciones observadas (infarto perioperatorio, accidente cerebrovascular, mediastinitis, hemorragia postoperatoria) fueron comparables a las observadas en cirugía con bomba 26,27 .…”

Section: Resultados Inmediatosunclassified

“…Exceptuando por la necesidad de revascularización, la mayoría de los autores concuerdan en que los resultados alejados son comparables entre ambas técnicas 22,[26][27][28][29] .…”

Section: Resultados Alejadosunclassified