Is There A Benefit In The Long-term Macce Results After Opcab Revascularization? A Retrospective Study In Over 3000 Patients
Marc Albert, Stefan Reichert, Adrian Ursulescu, Ulrich FW Franke.
Robert-Bosch-Hospital, Stuttgart, Germany.
Background:
Off-pump myocardial revascularization allows improved short-term results of coronary surgery regarding mortality and neurological outcome. Still, there is limited data about the long-term MACCE results in large cohort studies with long-term follow-up. This study demonstrates those results of more than 3000 patients.
Methods:Between 2006 and 2012 5915 patients received an isolated CABG procedure in our department. We excluded all patients receiving an emergency or re-do procedure and patients operated via left-sided mini-thoracotomy. Of the remaining 3217 patients, 2337 were operated off-pump, 880 on-pump. All patients were interviewed regarding survival, repeat revascularization, recurrence of angina and MACCE rate.
Results:
The perioperative data did not differ between the two groups. During the long-term follow up a significant advantage for the OPCAB-technique was found regarding cerebrovascular stroke and survival (see Tab. 1).
Conclusion:
Although the OPCAB-technique is described as more demanding for the surgeon compared to the on-pump revascularization, patients operated off-pump show a significant benefit regarding long-term survival and interestingly late-onset of cerebrovascular stroke.
| Off-Pump (n=2337) | On-Pump (n=880) | p-Value | |
| Recurrence of Angina [n] | 334 (14.3%) | 137 (15.6%) | 0.36 |
| Late Myocardial Infarction | 49 (2.1%) | 25 (2.8%) | 0.17 |
| Late Cerebrovascular Stroke | 75 (3.2%) | 43 (4.9%) | 0.02 |
| Repeat Revascularization | 21 (0.9%) | 10 (1.1%) | 0.61 |
| Long-Term, All-Cause Mortality | 171 (7.3%) | 128 (14.6%) | 0.001 |
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