Influence of on-pump versus off-pump techniques and completeness of revascularization on long-term survival after coronary artery bypass.
Ann Thorac Surg
; 86(3): 797-805, 2008 Sep.
Article
em En
| MEDLINE
| ID: mdl-18721564
ABSTRACT
BACKGROUND:
Off-pump coronary artery bypass graft surgery (OPCABG) may be associated with reduced morbidity and in-hospital mortality. In this study, we report the influence of surgery type, number of grafts, and the Index of Completeness of Revascularization (ICOR), namely, the number of grafts/number diseased vessel systems, on long-term survival.METHODS:
From 1997 to 2006, 12,812 consecutive patients underwent isolated CABG at a single academic center. Ten-year survival data were obtained by cross-referencing patients with the national Social Security Death Index. A propensity score analysis of 46 preoperative characteristics balanced risk factors between surgical groups. A proportional hazards regression analysis modeled the hazard of death as a function of surgery type (on versus off), distal group (1 to 3 versus 4 to 7 vessels), ICOR, and propensity score.RESULTS:
Proportional hazards regression analysis showed no significant influence of surgery type or number of grafts on long-term survival within the four groups OPCABG 1 to 3 grafts (n = 3,946; ICOR 1.11), OPCABG 4 to 7 grafts (n = 1,721; ICOR 1.56), on-pump CABG 1 to 3 grafts (n = 3,380; ICOR 1.21), and on-pump CABG 4 to 7 grafts (n = 3,765; ICOR 1.64). Irrespective of technique of revascularization, there was a survival advantage for patients with higher ICOR.CONCLUSIONS:
Long-term survival was similar for patients receiving 1 to 3 or 4 to 7 grafts by either on-pump or off-pump techniques. However, higher ICOR was associated with improved long- term survival within all groups.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ponte Cardiopulmonar
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Ponte de Artéria Coronária
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Ponte de Artéria Coronária sem Circulação Extracorpórea
Tipo de estudo:
Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article