Off-pump versus on-pump CABG surgery: how do the long-term graft patencies compare?
Gavin J Murphy and Gianni D Angelini*
Correspondence *Bristol Heart Institute, Bristol Royal Infirmary, Bristol BS2 8HW, UK
Email G.D.Angelini@bristol.ac.uk
This article has no abstract so we have provided the first paragraph of the full text.
CABG surgery on the beating heart (off-pump CABG) reduces postoperative morbidity and health care costs when compared with conventional CABG by avoiding the deleterious effects of cardiopulmonary bypass and cardioplegic arrest. The long-term success of CABG, however, is ultimately determined by graft patency and the completeness of revascularization. Concern remains that the technical demands associated with performing anastomoses on the beating heart could result in fewer grafts and suboptimum anastomoses. The PRAGUE-4 investigators have attempted to address these concerns in a prospective, randomized study, in which they report equivalent graft patency but fewer grafts per patient in the off-pump than the on-pump surgical groups. Several potentially confounding factors, however, limit the applicability of these results to coronary artery surgery in general.
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