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.
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.
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).
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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