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We have conflicting data about whether patients undergoing coronary artery bypass grafting benefit from the avoidance of cardiopulmonary bypass (off-pump, as compared with on-pump surgery). Investigators from the U.S. Department of Veteran Affairs sought to address this controversy by randomizing 2203 patients undergoing CABG to on-pump or off-pump procedures. All surgeons had performed at least 20 off-pump CABG surgeries (average, 120; median, 50). Almost all participants were men (mean age, 63). Fewer than 1% had previously undergone CABG, and almost 60% had LV ejection fractions ≥55%.
The rate of the primary short-term endpoint — a composite of death and various complications during or within 30 days after surgery — was nonsignificantly l…