Off-pump coronary bypass surgery in patients with low ejection fraction: Is there a long-term survival advantage?

Hagen Gorki, Nirav C. Patel, Georgia Panagopoulos, Joan Jennings, Lognathen Balacumaraswami, Konstadinos Plestis, Valavanur A. Subramanian

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Objective: Long-term survival after off-pump surgery in patients with low ejection fraction was investigated. Methods: Three hundred forty-six patients with ejection fraction 30% or less with isolated off-pump coronary artery bypass surgery (OPCAB) were compared with a propensity matched historical group operated on-pump (ONCAB) and with data from literature after percutaneous coronary intervention and OPCAB surgery. Results: The lower invasiveness of OPCAB contributed to a significantly better 30-day survival, shorter postoperative length of stay, and fewer in-hospital complications. Incomplete revascularization of the posterior and lateral territories of the heart correlated with higher 1-year mortality. The probability of survival for 8 years after OPCAB was 50.1% (n = 76) versus 49.7% (n = 82) for ONCAB without comparable data from literature for OPCAB or percutaneous coronary intervention in these high-risk patients. Conclusions: OPCAB surgery in patients with low ejection fraction is a viable alternative but so far without demonstrable long-term survival advantage to ONCAB.

Original languageEnglish (US)
Pages (from-to)33-41
Number of pages9
JournalInnovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2010

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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