Does off-pump coronary artery revascularization improve the long-term survival in patients with ventricular dysfunction?

摘要: OBJECTIVES Coronary artery revascularization with cardiopulmonary bypass (ONCAB) has been reported to carry several risks for patients poor left ventricular (LV) function (ejection fraction <30%). Off-pump CABG (OPCAB) proposed result in a better outcome, but mid- and long-term survival rates have never compared. The aim of this study is assess the effect on group patients. METHODS In 10-year period, total 934 LV undergoing isolated first-time coronary graft were studied. They divided into two groups, ONCAB group, 528 patients, OPCAB 406 EuroSCORE was significantly higher (P=0.049). After adjusting preoperative characteristics, postoperative complications, in-hospital mortality, mid-term rate (five years), (10 years) RESULTS average number grafts 3.7 3.1 (P<0.001). Postoperative complications groups such as; atrial fibrillation (29.6% vs. 28.6%), renal failure (9.3% 9.6%), stroke (2.3% 0.7%), perioperative myocardial infarction (MI) (3.8% 2.0%), comparable between groups. Length intensive care unit stay, hospital stay ventilation time considerably shorter (P<0.05). incidence wound infection also lower characteristics most remained same except MI, which OPCABs (P<0.04). Despite proximal anastomoses (0.09% 1.6%). In-hospital mortality compared (7.8% 5.7%), difference did not reach statistical significance (P=0.21). Likewise, similar even matched characteristics. However, re-intervention found be CONCLUSIONS benefits OPCAB, there no significant influence or dysfunction. With adequate protection complete results are achievable.