Abstract 17093: Long-term Survival After Off-pump Coronary Artery Bypass Graft Surgery: A Cohort Study
Introduction: Randomised controlled trials demonstrate that Off-Pump Coronary Artery Bypass (OPCAB) is equivalent to On-Pump Coronary artery bypass graft (ONCAB) for in-hospital and short-term outcomes. Recent observational data, however, suggests that OPCAB may be associated with increased mid-term mortality although there are several conflicting studies.
There is little data on long-term survival after OPCAB. The objective of this study was to determine the impact of OPCAB on long-term survival compared to ONCAB.
Methods: We conducted a retrospective cohort study using the Bristol PATS database of all patients who underwent primary isolated CABG surgery from 1996 to 2011. Mortality data was obtained from the Office of National Statistics. Multivariate regression models were used to estimate the association between OPCAB and long-term survival.
Results: We evaluated long-term survival in 11,981 patients (mean age 65.5±9.3 years, 2202 females) who underwent CABG (OPCAB, n=6133; ONCAB, n=5848). Survival data was complete in 99.2% of patients, with a median follow-up duration of 8 years (interquartile range: 4.8 to 11.8 years; maximum 17.3 years). Both groups were similar in terms of baseline characteristics and intraoperative variables. Euroscore was 3.7 (0.03) and 3.8 (0.03) and number of distal anastomoses performed were 2.53 (0.81) and 2.92 (0.78) in the OPCAB and ONCAB groups, respectively. Long-term survival was similar between patients undergoing OPCAB and ONCAB (HR for death: 0.94, 95%CI 0.87 - 1.01, p=0.087).
Conclusions: In patients undergoing coronary revascularisation both ONCAB and OPCAB offer excellent long-term survival.
Author Disclosures: N.N. Patel: None. F. Fiorentino: None. M.T. Sharabiani: None. G.D. Angelini: None.
- © 2015 by American Heart Association, Inc.