Graft patency after off-pump versus on-pump coronary artery surgery in high-risk patients.

OBJECTIVE: To compare angiographic graft patency in high-risk patients randomly allocated to off-pump vs. on-pump coronary artery bypass grafting (CABG). DESIGN: From a randomised, single-centre clinical trial including patients undergoing isolated first-time coronary bypass surgery a subgroup of patients were scheduled to 1-year coronary angiographic follow-up. Patients had 3-vessel disease and a EuroSCORE > or =5. We evaluated graft patency using a patency index (percentage of patent grafts out of the total number of grafts in each patient). RESULTS: One-year angiography was performed in 34 patients undergoing off-pump surgery and 35 patients undergoing on-pump surgery. The mean number of distal anastomoses was 3.38+/-0.65 in the off-pump group versus 3.46+/-0.61 in the on-pump group (NS). The number of patients without graft failure was 22 in the off-pump group and 24 in the on-pump group (NS). The overall patency index was 85% in the off-pump group versus 87% in the on-pump group with a mean difference of -2.1%, 95% confidence interval -12.9 to 8.7 (NS). CONCLUSIONS: In patients with 3-vessel disease and a high-risk profile we found no statistically significant difference in graft patency between off-pump and on-pump CABG at 1-year coronary angiographic follow-up.