Clinical Outcomes of Coronary Revascularization without Cardiopulmonary Bypass

OBJECTIVE: Coronary artery bypass without cardiopulmonary bypass (OPCAB) eliminates the complications related to cardiopulmonary bypass. However, the long-term outcomes of this procedure are largely unknown. METHODS: We sought to investigate the rates of late mortality, stroke, acute myocardial infarction, and target vessel reintervention after OPCAB in a consecutive series of 857 patients who underwent OPCAB between May 1987 and March 1999. RESULTS: Long-term follow-up was obtained for 86% of eligible patients. Actuarial and event-free survival was 89% and 76%, respectively, for a median follow-up period of 2.2 years (range, 0-13.3 years). Risk factors for late mortality were identified with Cox regression analysis. In the multivariate analysis, patient age >75 years (odds ratio, 1.1; 95% confidence interval, 1.0-1.1; P =.01) and an ejection fraction <35% (odds ratio, 2.7; 95% confidence interval, 1.2-6.2; P =.02) emerged as independent predictors of late mortality. CONCLUSION: OPCAB is associated with a low mortality and clinical event rate. Advanced age and depressed ejection fraction may increase mortality after OPCAB.