211282 Comparison of long-term graft patency of onpump versus off-pump coronary artery bypass grafting

/Wu Qiang(吳強(qiáng)，Dept Cardiac Surg，Beijing Anzhen Hosp，Cap Med Univ，100029)…∥Chin J Thorac Cardiovasc Surg.-2011，27(3).-170 ～172

ObjectiveOff-pump coronary artery bypass grafting(OPCAB)is used more widely in recent years in China.However，there is an argument on benefits and risks of off-pump surgery.Many studies shown that OPCAB had more benefits in short-term outcomes than conventional coronary artery bypass grafting(CCABG).But evidences from other studies suggested that OPCAB resulted in less long-term graft patency as compared with on-pump surgery.This study examined the long-term graft patency of OPCAB and CCABG performed by one surgeon.Methods50 patients who had received surgical revascularization by a surgeon for more than 5 years were reviewed，25 patients received conventional coronary artery bypass grafting(group 1)and 25 patients received OPCAB(group 2).All patients had angiograms for comparing the graft patency between the two groups.ResultsAmong 25 patients in group 1，21 were male and 4 were female.The mean age of patients at surgery was(55.4 ±8.9)years.15 cases had unstable angina，16 patients had old myocardial infarction and 6 cases had diabetes.The ejection fraction(EF)was 0.58 ±0.14.The mean number of bypasses per patient was 3.32 ± 0.63.Mean duration of operation was(3.58 ± 0.82)hours.Mean follow-up duration was(86.52 ±12.48)months.83 grafts were evaluated for patency(open vs.closed)and were graded by Fitzgibbon as grade A(excellent graft)，B(impaired graft，with a stenosis of≥50%，or a diameter less than 50%of the grafted artery)，or O(completely occluded).The graft patency was 73.49%，61grafts were graded as Fitzgibbon A，6 grafts as Fitzgibbon B and 16 grafts as Fitzgibbon 0.25 patients were in group 2，21 males and 4 females.The mean age of patients at procedure was(58.2 ± 9.09)years，11 patients had unstable angina，13 patients had old myocardial infarction and 6 cases had diabetes.The ejection fraction(EF)was 0.59 ± 0.14.ConclusionNo difference in long-term graft patency was identified between on-pump and off-pump coronary artery bypass grafting.Off-pump coronary artery bypass grafting performed by an experienced surgeon may gain the long-term graft patency similar to that gained by conventional bypass.11 refs，1 tab.