Long-Term Follow-up of Off-Pump and On-Pump Coronary Artery Bypass Grafting

2014 ◽  
Vol 9 (2) ◽  
pp. 122-129 ◽  
Author(s):  
Shahzad G. Raja ◽  
Umberto Benedetto ◽  
Dimple Chudasama ◽  
Siobhan Daley ◽  
Mubassher Husain ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Off Pump ◽  
Long Term Follow Up ◽  
Pump Cabg ◽  
Pump Coronary Artery Bypass ◽  
Long Term Mortality

Objective Despite increasing recognition of the benefits of off-pump coronary artery bypass grafting (CABG), concerns persist regarding its impact on long-term mortality and freedom from reintervention. In this study, we assessed the impact of off-pump CABG on long-term outcomes. Methods From January 2002 to December 2002, a total of 307 consecutive patients who underwent isolated multivessel off-pump CABG at our institution were compared with a control group of 397 patients who underwent multivessel on-pump CABG during the same period. Perioperative data were prospectively collected and compared. In addition, univariate and risk-adjusted comparisons between the two groups were performed at 10 years. Results After adjusting for clinical covariates, off-pump CABG did not emerge as a significant independent predictor of long-term mortality [hazard ratio (HR), 0.91; 95% confidence interval (CI), 0.70–1.12], readmission to hospital for cardiac cause (HR, 0.96; 95% CI, 0.78–1.10), or the need for reintervention (HR, 0.93; 95% CI, 0.87–1.05). Conclusions At long-term follow-up, off-pump CABG remains a safe and effective myocardial revascularization strategy with no adverse impact on survival or freedom from reintervention.

Long-Term Follow-up of Off-Pump and On-Pump Coronary Artery Bypass Grafting

2014 ◽  
Vol 9 (2) ◽  
pp. 122-129
Author(s):  
Shahzad G. Raja ◽  
Umberto Benedetto ◽  
Dimple Chudasama ◽  
Siobhan Daley ◽  
Mubassher Husain ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Off Pump ◽  
Long Term Follow Up ◽  
Pump Coronary Artery Bypass

scholarly journals A Risk Score for Predicting Long-Term Mortality Following Off-Pump Coronary Artery Bypass Grafting

2021 ◽  
Vol 10 (14) ◽  
pp. 3032
Author(s):  
Tomasz Kamil Urbanowicz ◽  
Michał Michalak ◽  
Aleksandra Gąsecka ◽  
Anna Olasińska-Wiśniewska ◽  
Bartłomiej Perek ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Risk Score ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Off Pump ◽  
All Cause Mortality ◽  
Pump Coronary Artery Bypass ◽  
Long Term Mortality

Background: Off-pump coronary artery bypass grafting (OPCAB) comprises 15–30% of all bypass grafting surgeries. The currently available perioperative scores such as Euroscore and STS score do not specifically predict long-term mortality after off-pump procedures. The neutrophil-to-lymphocyte ratio (NLR) is one of the new, easily accessible markers of inflammation with proven predictive value in cardiovascular diseases. We aimed to develop the first risk score for long-term mortality after OPCAB and to determine if the perioperative value of NLR predicts long-term mortality in OPCAB patients. Methods: In total, 440 consecutive patients with multivessel stable coronary artery disease undergoing OPCAB were recruited. Differential leukocyte counts were obtained by a routine hematology analyzer. Data regarding mortality during a median follow-up time of 5.3 years were obtained from the Polish National Health Service database. An independent population of 242 patients served as a validation cohort. Results: All-cause mortality was influenced by different clinical risk factors. In multivariate regression analysis, chronic obstructive pulmonary disease, stroke history, post-operative NLR and LVEF were independent predictors of mortality. Combing all independent predictors predicted long-term all-cause mortality with 68.5% sensitivity and 71.5% specificity (AUC = 0.704, p < 0.001). After weighing these variables according to their estimates in a multivariate regression model, we developed a score to predict mortality in patients undergoing OPCAB (PREDICT-OPCAB Score, ranging from 0 to 10). Patients with a high score were at higher risk of mortality within the median 5.3 years of follow-up (score 0–3: 8.3%; 4–6: 27.0%; 7–10: 40.0%; p < 0.001 for score 0–3 vs. 4–6 and 7–10). This association was confirmed in the validation cohort. Conclusions: We developed and validated the first simplified risk score to predict mortality following OPCAB based on easily accessible clinical factors. This risk score can be used when obtaining a patient’s informed consent and as an aid in determining treatment.

scholarly journals Off-pump versus on-pump redo coronary artery bypass grafting: A propensity score analysis of long-term follow-up

2020 ◽  
Vol 159 (2) ◽  
pp. 447-456.e2 ◽  
Author(s):  
Magdalena Iuliana Rufa ◽  
Adrian Ursulescu ◽  
Ragi Nagib ◽  
Selvaraj Shanmuganathan ◽  
Marc Albert ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Propensity Score Analysis ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Off Pump ◽  
Score Analysis ◽  
Long Term Follow Up

scholarly journals The Prognostic Significance of Neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR) on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) Procedures

Biology ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 34
Author(s):  
Tomasz Urbanowicz ◽  
Anna Olasińska-Wiśniewska ◽  
Michał Michalak ◽  
Michał Rodzki ◽  
Anna Witkowska ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Multivariable Analysis ◽  
Bypass Grafting ◽  
Off Pump ◽  
Lymphocyte Ratio ◽  
Pump Coronary Artery Bypass ◽  
Long Term Mortality

Background: Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. Method and results: The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60–71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/− 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33–4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09–2.79, p = 0.019) were found significant for long-term mortality prediction in multivariable analysis. Conclusion: Hematological indices NLR and MLR can be regarded as significant predictors of all-cause long-term mortality after OPCAB revascularization. Multivariable analysis revealed preoperative values of MLR > 0.2 and postoperative values of NLR > 3.5 as simple, reliable factors which may be applied into clinical practice for meticulous postoperative monitoring of patients in higher risk of worse prognosis.

Ten-Year Outcome Analysis of Off-Pump Sequential Grafting: Single Surgeon, Single Center Experience

2012 ◽  
Vol 15 (3) ◽  
pp. 136 ◽  
Author(s):  
Shahzad G. Raja ◽  
Kareem Salhiyyah ◽  
Manoraj Navaratnarajah ◽  
Muhammad Umar Rafiq ◽  
Jeremy Felderhof ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Medium Term ◽  
Artery Bypass Grafting ◽  
Off Pump ◽  
Pump Coronary Artery Bypass

<p><b>Objectives:</b> Despite increasing recognition that off-pump coronary artery bypass surgery and sequential grafting strategy individually are associated with improved outcomes, concerns persist regarding the safety and efficacy of combining these 2 techniques. We compared in-hospital and midterm outcomes for off-pump multivessel sequential and conventional coronary artery bypass grafting.</p><p><b>Methods:</b> From September 1998 to September 2008, 689 consecutive patients received off-pump multivessel sequential coronary artery bypass grafting performed by a single surgeon. These patients were propensity matched to 689 patients who underwent off-pump coronary artery bypass grafting without sequential anastomoses. A retrospective analysis of prospectively collected perioperative data was performed. In addition, medical notes and charts of all the study patients were reviewed. The mean duration of follow-up was 5.1 � 2.0 years.</p><p><b>Results:</b> The major in-hospital clinical outcomes in the sequential and control groups were found to be similar. After adjusting for clinical covariates, sequential grafting was not an independent predictor of in-hospital adverse events (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.86-1.50; <i>P</i> = .31), medium-term mortality (hazard ratio [HR], 1.26; 95% CI, 1.06-1.32; <i>P</i> = .92), and readmission to hospital (HR, 1.12; 95% CI, 0.96-1.20; <i>P</i> = .80). Sequential grafting was an independent predictor of receiving more than 3 distal anastomoses (OR, 7.46; 95% CI, 4.27-11.45; <i>P</i> < .0001). Risk-adjusted survival was 89% for sequential grafting patients and 88% for conventional grafting patients (<i>P</i> = .96) during the medium-term follow-up.</p><p><b>Conclusion:</b> Our analysis confirms the short- and midterm safety and efficacy of off-pump sequential coronary artery bypass grafting.</p>

scholarly journals Does Age at Operation Influence the Short- and Long-Term Outcomes of Off-Pump Coronary Artery Bypass Grafting?

2015 ◽  
Vol 79 (10) ◽  
pp. 2177-2185 ◽  
Author(s):  
Suguru Ohira ◽  
Kiyoshi Doi ◽  
Satoshi Numata ◽  
Sachiko Yamazaki ◽  
Tsunehisa Yamamoto ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Long Term Outcomes ◽  
Off Pump ◽  
Short And Long Term ◽  
Pump Coronary Artery Bypass
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