On-Pump vs. Off-Pump Coronary Artery Bypass Grafting: A Big Picture

Findings from a large, observational study confirm lower short-term complication rates but higher long-term revascularization rates with OPCAB.

Using data from a registry of all patients who undergo cardiac surgery in New York State, investigators compared outcomes from 2001 through 2004 in 35,941 patients who had on-pump coronary artery bypass grafting (CABG) with those in 13,889 patients who had off-pump CABG (OPCAB).

OPCAB patients were slightly but significantly older (67 vs. 66) and more likely to be women (29% vs. 27%) than on-pump patients. Other important risk factors differed significantly between the groups; overall, on-pump patients had significantly lower mean risk scores (as determined by the New York Cardiac Surgery Reporting System model) than off-pump patients. Risk-adjusted early mortality was significantly lower in OPCAB patients (odds ratio, 0.81) than in on-pump …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)