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Eight-Year Experience of Total Arterial Off-pump CABG With Early And Postoperative One-Year Angiography

K. Kim, K. R. Cho, D. S. Jeong. Seoul National University Hospital, Seoul, Republic of Korea,


BACKGROUND:We assessed the early postoperative and one-year results after total arterial off-pump coronary artery bypass (OPCAB).
METHODS:Of Eight hundred and thirty four OPCABs performed between 1998 and 2004, we compared the results of patients using total arterial grafts (group A; n=699) with those using one or more saphenous vein grafts (group B; n=135). Coronary angiographies were performed early (n=804; postoperative day 1.6±1.5) and one year (n=671; 12.1±4.2 mo) after surgery.
RESULTS:There were no significant differences in patient characteristics, operative mortalities and postoperative morbidities between the two groups (p=ns). Early postoperative angiographies showed higher overall patency of group A than group B (99.1% vs 90.9%), which might be affected by a low saphenous vein patency in group B. There was no difference in the internal thoracic artery (ITA) pateny between the two groups (99.1% vs 97.1%). Postoperative one-year angiographies showed higher overall patency of group A than group B (95.0% vs 78.8%), which might also be affected by a low saphenous vein patency. There was no difference in the one-year ITA pateny between the two groups (95.6% vs 94.2%). Target vessel revascularization rate in the postoperative one year was significantly lower in group A than in group B (2.0% vs 7.4%, p=0.002).CONCLUSIONS:
Total arterial OPCAB demonstrated a high patency rate at both early and one year after surgery, resulting in a low target vessel revascularization rate.
Comparison of graft patency
Group AGroup Bp
EarlyTotal99.1% (1900/1918)90.9% (390/429)0.02
ITA99.1% (1425/1438)97.1% (170/175)ns
SVG-86.4% (210/243)-
One-yrTotal95.0% (1514/1594)78.8% (305/387)<0.001
ITA95.6% (1174/1226)94.2%(146/155)ns
SVG-67.9%, 148/218-

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