Key result
Off-pump multivessel coronary artery bypass was associated with significantly lower rates of operative mortality, permanent stroke, renal failure, and perioperative MI compared to on-pump bypass.
Why the study?
Does off-pump multivessel coronary artery bypass reduce operative morbidity and mortality compared to on-pump bypass in patients with multivessel coronary disease?
Cohort (n=7,223)
No
Does off-pump multivessel coronary artery bypass reduce operative morbidity and mortality compared to on-pump bypass in patients with multivessel coronary disease?
Off-pump multivessel CABG was associated with lower perioperative complications and mortality compared to on-pump CABG, though findings are likely confounded by higher baseline risk in the on-pump cohort.
May warrant caution in adopting off-pump CABG; leaves open causal benefit after confounder adjustment in RCTs.
Outcomes of off-pump multivessel coronary artery bypass were compared with those of the on-pump procedure. From July 2001 to June 2006, 3,637 patients with multivessel coronary disease underwent off-pump coronary artery bypass, and 3,586 patients had on-pump coronary artery bypass in our center. The rates of operative mortality, permanent stroke, renal failure and perioperative myocardial infarction were significantly lower in the off-pump group, and these patients required fewer blood transfusions, shorter durations of ventilatory support, and shorter hospital stays. However, the patients who underwent on-pump coronary artery bypass were considered more high-risk and tended to have more complex procedures.
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Sun et al. (2009) conducted a cohort in Multivessel coronary disease (n=7,223). Off-pump multivessel coronary artery bypass vs. On-pump coronary artery bypass was evaluated on Operative mortality, permanent stroke, renal failure and perioperative myocardial infarction. Off-pump multivessel coronary artery bypass was associated with significantly lower rates of operative mortality, permanent stroke, renal failure, and perioperative MI compared to on-pump bypass.
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