Outcomes of on-pump versus off-pump coronary artery bypass graft surgery in the high risk (AusSCORE > 5)

Vikrant Dhurandhar, Akshat Saxena, Roneil N Parikh, Michael P Vallely, Michael Keith Wilson, Jennifer Kay Butcher, Deborah Black, Lavinia Tran, Christopher Michael Reid, Paul G Bannon

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13 Citations (Scopus)

Abstract

Background: Coronary artery bypass graft surgery (CABG) has been established as the preferred intervention for coronary revascularisation in the high-risk population. Off-pump coronary artery bypass (OPCAB) may further reduce mortality and morbidity in this population subgroup. This study presents the largest series of high-risk (AusSCORE > 5) OPCAB patients in Australia and New Zealand. Methods: We reviewed the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database for high-risk patients (n=7822) undergoing isolated CABG surgery and compared the on-pump coronary artery bypass (ONCAB) (n=7277) with the OPCAB (n=545) technique. Preoperative and intraoperative risk factors, and postoperative outcomes were analysed. Survival analysis was performed after cross-matching the database with the national death registry to identify long-term mortality. Results: The ONCAB and OPCAB groups had similar risk profiles based on the AusSCORE. Thirty-day mortality (ONCAB vs OPCAB 3.9 vs 2.4 , p=0.067) and stroke (ONCAB vs OPCAB 2.4 vs 1.3 , p=0.104) were similar between the two groups. OPCAB patients received fewer distal anastomoses than ONCAB patients (2.5?1.2 vs 3.3?1.0, p
Original languageEnglish
Pages (from-to)1216 - 1224
Number of pages9
JournalHeart Lung and Circulation
Volume24
Issue number12
DOIs
Publication statusPublished - 2015

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