Long-term follow-up of off-pump and on-pump coronary artery bypass grafting.

Overview

OBJECTIVE: Despite increasing recognition of the benefits of off-pump coronary artery bypass grafting (CABG), concerns persist regarding its impact on long-term mortality and freedom from reintervention. In this study, we assessed the impact of off-pump CABG on long-term outcomes. METHODS: From January 2002 to December 2002, a total of 307 consecutive patients who underwent isolated multivessel off-pump CABG at our institution were compared with a control group of 397 patients who underwent multivessel on-pump CABG during the same period. Perioperative data were prospectively collected and compared. In addition, univariate and risk-adjusted comparisons between the two groups were performed at 10 years. RESULTS: After adjusting for clinical covariates, off-pump CABG did not emerge as a significant independent predictor of long-term mortality [hazard ratio (HR), 0.91; 95% confidence interval (CI), 0.70-1.12], readmission to hospital for cardiac cause (HR, 0.96; 95% CI, 0.78-1.10), or the need for reintervention (HR, 0.93; 95% CI, 0.87-1.05). CONCLUSIONS: At long-term follow-up, off-pump CABG remains a safe and effective myocardial revascularization strategy with no adverse impact on survival or freedom from reintervention.