Institutional report - Coronary Totally arterial off-pump vs. on-pump coronary revascularization: comparison of early outcome

Our objective was to assess differences in early outcome after completely arterial myocardial revascularization with (on-pump coronary artery bypass grafting or ONCAB) or without cardiopulmonary bypass (off-pump coronary artery bypass grafting or OPCAB). Fifty-eight OPCAB and 91 ONCAB patients receiving exclusively arterial grafts were analyzed. OPCAB patients had more single-vessel ðP , 0:0001Þ; less triple-vessel ðP , 0:0001Þ or left main disease ðP ¼ 0:0021Þ; higher angina class ðP ¼ 0:003Þ; more unstable angina ðP , 0:0001Þ and previous percutanueous transluminal coronary angioplasty (PTCA; P , 0:0001), but similar EuroScores ðP ¼ n:s:Þ: ONCAB was associated with longer operation time ðP ¼ 0:0001Þ and more anastomoses/patient ðP , 0:0001Þ: Internal thoracic artery (ITA) use was identical, whereas single left ITA use ðP , 0:0001Þ and left ITA jump anastomoses ðP , 0:0001Þ were more frequent in OPCAB. Radial artery (RA) use ðP , 0:0001Þ and RA jump anastomoses ðP , 0:0001Þ were more frequent in ONCAB. Complication rates were similar concerning mortality, arrhythmias, cerebro-vascular accidents (CVA), and renal failure with shorter ventilatory support ðP , 0:0001Þ and a trend towards less perioperative myocardial infarction (PMI) ðP ¼ 0:12Þ and low output ðP ¼ 0:089Þ; and more respiratory complications ðP ¼ 0:056Þ after OPCAB. Arterial OPCAB patients have less extensive CAD, but more severe symptoms. Early outcome is similar concerning mortality, arrhythmias, CVA, renal failure, or intensive care unit and hospital stay, but with shorter ventilatory support and a trend towards lower PMI and low output, and higher respiratory complication rates after OPCAB. q 2003 Elsevier B.V. All rights reserved.