Letter by Salzberg et al Regarding Article, “Should Off-Pump Coronary Artery Bypass Grafting Be Abandoned?”
To the Editor:
We read with interest the article by Dr Lazar1 presenting his personal opinions about off-pump coronary surgery (OPCAB) and concluding that it should be abandoned. It is our belief that these conclusions are based on several factual errors and multiple inaccurate statements.
First, the statement “Retrospective nonrandomized, prospective randomized, and meta-analyses trials have failed to show any significant improvement in short-term morbidity or mortality with OPCAB techniques” is erroneous. Numerous large retrospective studies and meta-analyses have shown significant short-term improvements after OPCAB and comparable long-term outcomes.2–4 A recent risk-adjusted analysis of the national Society of Thoracic Surgeons database assessing 876 081 patients demonstrated a significant reduction in death and stroke (11% and 34% reduction, respectively) after OPCAB, seen in both low- and high-volume centers. Börgermann and colleagues2 performed propensity matching on 1282 patients who underwent either …