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Thorac Cardiovasc Surg 2007; 55(1): 13-18
DOI: 10.1055/s-2006-924484
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Off-Pump versus On-Pump Coronary Artery Bypass Surgery in High-Risk Patients (EuroSCORE ≥ 6)

J. Lahtinen1 , F. Biancari1 , J. Rimpiläinen1 , R. Kytökorpi1 , M. Mosorin1 , P. Rainio1 , R. Cresti1 , T. Juvonen1 , M. Lepojärvi1
  • 1Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland
Further Information

Publication History

received April 11, 2006

Publication Date:
06 February 2007 (online)

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Abstract

Objective: The aim of this study was to review the results of off-pump (OPCAB) versus conventional on-pump coronary artery bypass surgery (CCAB) in high-risk patients. Methods: In a cohort of patients with an additive EuroSCORE ≥ 6, 67 underwent OPCAB and 112 underwent CCAB. Results: Thirty-day postoperative death and stroke rates were 7.5 % and 6.0 % for the OPCAB group, and 5.4 % (p = 0.75) and 8.0 % (p = 0.77) for the CCAB group, respectively. No significant differences were observed for other major outcome endpoints other than cardiac troponin I (OPCAB: 117 ± 428 ng/ml vs. CCAB: 58 ± 99 ng/ml, p = 0.028), a result which was probably due to preoperative massive myocardial infarction in two very high-risk patients who underwent OPCAB. A similar outcome was also observed among propensity score-matched pairs. Congestive heart failure (p = 0.006, OR: 6.366, 95 % CI: 1.682 - 24.093) and baseline cardiac index (p = 0.018, OR: 0.171, 95 % CI: 0.040 - 0.735) were independent predictors of 30-day postoperative mortality. Conclusions: OPCAB can be safely performed in high-risk patients with results as satisfactory as those achieved with CCAB.

Key words

cardiovascular surgery - heart disease - coronary bypass surgery

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MD, PhD Fausto Biancari

Division of Cardiothoracic and Vascular Surgery
Department of Surgery
Oulu University Hospital

P. O. Box 21

90029 Oulu

Finland

Phone: + 35 8 83 15 28 13

Fax: + 35 8 83 15 25 77

Email: fausto.biancari@ppshp.fi