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A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE

BACKGROUND: The aim of the present study was to evaluate and compare postoperative short-term, mid-term and long-term outcomes of coronary artery bypass surgery performed with or without cardiopulmonary bypass in patients with a low European System for Cardiac Operative Risk Evaluation score. METHOD...

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Autores principales: Ercan, Abdulkadir, Karal, Ilker Hasan, Gurbuz, Orcun, Kumtepe, Gencehan, Onder, Tolga, Saba, Davit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075984/
https://www.ncbi.nlm.nih.gov/pubmed/24942178
http://dx.doi.org/10.1186/1749-8090-9-105
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author Ercan, Abdulkadir
Karal, Ilker Hasan
Gurbuz, Orcun
Kumtepe, Gencehan
Onder, Tolga
Saba, Davit
author_facet Ercan, Abdulkadir
Karal, Ilker Hasan
Gurbuz, Orcun
Kumtepe, Gencehan
Onder, Tolga
Saba, Davit
author_sort Ercan, Abdulkadir
collection PubMed
description BACKGROUND: The aim of the present study was to evaluate and compare postoperative short-term, mid-term and long-term outcomes of coronary artery bypass surgery performed with or without cardiopulmonary bypass in patients with a low European System for Cardiac Operative Risk Evaluation score. METHODS: A retrospective analysis of 478 consecutive low risk patients undergoing coronary bypass surgery between January 2002 and December 2007 was performed. Of these patients, 83 cases had undergone on-pump and 395 cases had undergone off-pump coronary bypass surgery. The patients were assessed in terms peri-operative complications, survival, mortality due to cardiac events, need for rehospitalization and repeated coronary revascularization. RESULTS: There was no significant difference between the two groups in terms of preoperative characteristics, except for chronic obstructive pulmonary disease. The number of distal anastomosis per patient was significantly lower in the off-pump group than in the on-pump group (2.66 ± 0.74 vs. 3.21 ± 0.85, p < 0.001). Early mortality rates were similar in both groups (1.01% for the off-pump group and 1.2% for the on-pump group, p = 0.687). Neurological complications were significantly lower in the off-pump group than in the on-pump group (1.1% vs. 6%, p = 0.01). The mean follow-up period was 80 ± 19.1 months (range, 3–112 months). The need for revascularization during long-term follow-up was 10.1% in the off-pump group and 7.2% in the on-pump group (p = 0.416). The 5-year survival was 95.2 ± 1.1% and 95.5 ± 2.7% in the off-pump and on-pump groups, respectively (p = 0.8), whereas the 7-year survival was 91.9 ± 1.6% and 84.7 ± 6.8% in the off-pump and on-pump groups, respectively (p = 0.274). The 5-year revascularization-free period was 89.5 ± 1.6% and 89.7 ± 3.5% in the off-pump and on-pump groups, respectively (p = 0.785). The 7-year revascularization-free period was 71.1 ± 3.1% and 73.5 ± 7.3% in the off-pump and on-pump groups, respectively (p = 0.075). The 7-year event-free survival was 80.1 ± 2.2% and 73.4 ± 7.3% in the off-pump and on-pump groups, respectively (p = 0.377). CONCLUSIONS: The present study demonstrated that off-pump cardiac surgery had advantages over on-pump cardiac surgery in the short term; however, both interventions had similar mid-term and long-term outcomes, when performed in low-risk patient.
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spelling pubmed-40759842014-07-01 A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE Ercan, Abdulkadir Karal, Ilker Hasan Gurbuz, Orcun Kumtepe, Gencehan Onder, Tolga Saba, Davit J Cardiothorac Surg Research Article BACKGROUND: The aim of the present study was to evaluate and compare postoperative short-term, mid-term and long-term outcomes of coronary artery bypass surgery performed with or without cardiopulmonary bypass in patients with a low European System for Cardiac Operative Risk Evaluation score. METHODS: A retrospective analysis of 478 consecutive low risk patients undergoing coronary bypass surgery between January 2002 and December 2007 was performed. Of these patients, 83 cases had undergone on-pump and 395 cases had undergone off-pump coronary bypass surgery. The patients were assessed in terms peri-operative complications, survival, mortality due to cardiac events, need for rehospitalization and repeated coronary revascularization. RESULTS: There was no significant difference between the two groups in terms of preoperative characteristics, except for chronic obstructive pulmonary disease. The number of distal anastomosis per patient was significantly lower in the off-pump group than in the on-pump group (2.66 ± 0.74 vs. 3.21 ± 0.85, p < 0.001). Early mortality rates were similar in both groups (1.01% for the off-pump group and 1.2% for the on-pump group, p = 0.687). Neurological complications were significantly lower in the off-pump group than in the on-pump group (1.1% vs. 6%, p = 0.01). The mean follow-up period was 80 ± 19.1 months (range, 3–112 months). The need for revascularization during long-term follow-up was 10.1% in the off-pump group and 7.2% in the on-pump group (p = 0.416). The 5-year survival was 95.2 ± 1.1% and 95.5 ± 2.7% in the off-pump and on-pump groups, respectively (p = 0.8), whereas the 7-year survival was 91.9 ± 1.6% and 84.7 ± 6.8% in the off-pump and on-pump groups, respectively (p = 0.274). The 5-year revascularization-free period was 89.5 ± 1.6% and 89.7 ± 3.5% in the off-pump and on-pump groups, respectively (p = 0.785). The 7-year revascularization-free period was 71.1 ± 3.1% and 73.5 ± 7.3% in the off-pump and on-pump groups, respectively (p = 0.075). The 7-year event-free survival was 80.1 ± 2.2% and 73.4 ± 7.3% in the off-pump and on-pump groups, respectively (p = 0.377). CONCLUSIONS: The present study demonstrated that off-pump cardiac surgery had advantages over on-pump cardiac surgery in the short term; however, both interventions had similar mid-term and long-term outcomes, when performed in low-risk patient. BioMed Central 2014-06-19 /pmc/articles/PMC4075984/ /pubmed/24942178 http://dx.doi.org/10.1186/1749-8090-9-105 Text en Copyright © 2014 Ercan et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Ercan, Abdulkadir
Karal, Ilker Hasan
Gurbuz, Orcun
Kumtepe, Gencehan
Onder, Tolga
Saba, Davit
A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE
title A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE
title_full A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE
title_fullStr A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE
title_full_unstemmed A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE
title_short A comparison of off-pump and on-pump coronary bypass surgery in patients with low EuroSCORE
title_sort comparison of off-pump and on-pump coronary bypass surgery in patients with low euroscore
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075984/
https://www.ncbi.nlm.nih.gov/pubmed/24942178
http://dx.doi.org/10.1186/1749-8090-9-105
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