Off-pump coronary artery bypass grafting provides complete revascularization with reduced myocardial injury, transfusion requirements, and length of stay: A prospective randomized comparison of two hundred unselected patients undergoing off-pump versus conventional coronary artery bypass grafting

摘要: Abstract Objective: Retrospective comparisons of selected patients undergoing off-pump versus conventional on-pump coronary artery bypass grafting have yielded inconsistent results and raised concerns about completeness revascularization in grafting. Methods: Two hundred unselected referred for elective primary were randomly assigned to undergo with an Octopus tissue stabilizer (Medtronic, Inc, Minneapolis, Minn) or cardiopulmonary by a single surgeon. Revascularization intent determined before random assignment was compared the performed. All management followed strict, unbiased, criteria-driven protocols. Patients nonoperative care providers blinded surgical group. Results: Baseline characteristics similar. The number grafts performed per patient (mean ± SD 3.39 1.04 grafting, 3.40 1.08 grafting) index (number performed/number intended, 1.00 0.18 1.01 0.09 Likewise, similar between groups lateral wall. Combined hospital 30-day mortalities stroke rates Postoperative myocardial serum enzyme measures significantly lower after suggesting less injury. Adjusted postoperative thromboelastogram indices, fibrinogen, international normalized ratio, platelet levels all showed coagulopathy received fewer units blood, more likely avoid transfusion altogether, had higher hematocrit at discharge. Cardiopulmonary independent predictor (odds ratio 2.42, P =.0073) multivariate analysis. More extubated operating room within 4 hours. length stay (in days) shorter (5.1 6.5 6.1 8.2 =.005 Wilcoxon test). One group) required angioplasty graft closure 30 days. Conclusions: When bypass, achieved revascularization, in-hospital outcomes, stay, reduced requirement, J Thorac Cardiovasc Surg 2003;125:797-808