0
Abstract: Poster Presentations |

OFF-PUMP CORONARY ARTERY BYPASS SURGERY IN A LOW CASE LOAD CENTER: MID-TERM FOLLOW-UP OF THE FIRST 107 PATIENTS FREE TO VIEW

Parwis Massoudy, MD*; Matthias Thielmann, MD; Julia Schäfer, MS; Eva Assenmacher, MD; Christian Lösch; Axel Schmermund, MD; Ivan Aleksic, MD; Jarowit A. Piotrowski, MD; Walter O. Schüler, MD; Peter Kienbaum, MD; Raimund Erbel, MD; Heinz Jakob, MD
Author and Funding Information

West German Heart Center, Department of Thoracic and Cardiovascular Surgery, Essen, Germany


Chest


Chest. 2005;128(4_MeetingAbstracts):266S. doi:10.1378/chest.128.4_MeetingAbstracts.266S-a
Text Size: A A A
Published online

Abstract

PURPOSE:  Off pump coronary artery bypass (OPCAB) grafting is still discussed controversially in the cardiac surgical community. Early perioperative results are encouraging. Only few reports have focused on mid-term recurrence of angina and freedom from death or re-intervention.

METHODS:  107 OPCAB patients (mean age 63±1 years, 77 male, mean additive EuroScore 4.1±0.3, mean logistic EuroScore 5.6±0.7%, number of distal anastomoses 2.0±0.1), operated on between January 1999 and December 2003, were systematically followed up comparing pre- and post-operative NYHA- and CCS-classifications and assessing freedom from death and re-intervention. 52 of 107 patients underwent postoperative angiography or multi-slice computed tomography (MSCT). 24 of the latter 52 patients were symptomatic, 21 with stable angina, 3 with unstable angina, the others underwent follow-up studies having given their informed consent.

RESULTS:  Perioperative 30 day mortality was 3%. Freedom from death or re-intervention at 5.5 years was 91% and 80%, respectively. Only three patients required re-intervention in an OPCAB-related vessel. CCS classification was 2.8±0.1 before surgery and 1.8±0.2 (p<0.01) at follow-up (3.3±0.3 years). NYHA classification was 2.7±0.1 and 2.2±0.1 (p<0.01), respectively. 52 patients (24 for cardiac symptoms) underwent coronary angiography or MSCT at a mean follow-up of 2.2±0.3 years. Left internal thoracic artery was patent in 91%, venous graft patency rate was 83%.

CONCLUSION:  In this small but consecutive OPCAB population with a considerable perioperative risk according to the EuroScore, freedom from death and re-intervention at 5.5 years is acceptable and graft patency rate at 2.2±0.3 years is in the expected range. Significant reduction in both CCS and NYHA classification indicate sustained clinical improvement at mid-term.

CLINICAL IMPLICATIONS:  Even with a low case load, reserving OPCAB to selected indications, surgery can be performed at low operative mortality and acceptable mid-term results.

DISCLOSURE:  Parwis Massoudy, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543