PMID- 19995794
OWN - NLM
STAT- MEDLINE
DCOM- 20100604
LR  - 20100226
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 10
IP  - 3
DP  - 2010 Mar
TI  - Five years follow-up after Y-graft arterial revascularization: on pump versus off 
      pump; prospective clinical trial.
PG  - 423-7
LID - 10.1510/icvts.2009.206458 [doi]
AB  - OBJECTIVES: We report our comparative experience of on-pump and off-pump full 
      arterial coronary artery bypass grafting (CABG) using both internal mammary 
      arteries (IMAs) anastomosed as a Y-graft. METHODS: A single-center clinical study 
      was conducted prospectively between January 2003 and May 2008. It compared the 
      short- and mid-term clinical outcomes of on- and off-pump arterial 
      revascularization where the left internal mammary artery (LIMA) was anastomosed 
      to the left anterior descending (LAD) artery while the free right internal 
      mammary artery (RIMA) graft taking off from the LIMA was used to bypass different 
      coronary targets. RESULTS: One hundred and ninety-two patients were divided into 
      77 on-pump and 115 off-pump procedures based on the intention to treat. The mean 
      age in both groups was 60.2+/-11.7 and 68.1+/-10.6 years, respectively (P<0.05). 
      Mean predictive logistic EuroSCORE was 3.5+/-6.7% for the on-pump group and 
      7.3+/-8.6% for the off-pump group (P<0.0001). Mean number of distal anastomoses 
      were 2.7+/-0.6 (group ON) and 2.5+/-0.6 (group OFF) (P=NS). Postoperative 
      mortality was two patients (2.6%) in the on-pump group and four patients (3.4%) 
      in the off-pump group (P=0.63). No major adverse cardiac event, no stroke and no 
      late death were reported during the follow-up that averaged 36.5+/-18.6 months. 
      Angina recurrence was three patients (2.6%) in off-pump and two patients (3.5%) 
      in on-pump group (P=NS). CONCLUSIONS: The use of a free RIMA as Y-graft from the 
      LIMA performed off pump eradicates aortic manipulations and provides complete 
      revascularization to high-risk patients with mortality similar to the one of a 
      lower risk population operated on pump. The morbidity and cost was lower in the 
      off-pump group. This advocates for the widespread usage of the technique in 
      high-risk patients.
FAU - Ramadan, Ahmed S E
AU  - Ramadan AS
AD  - Department of Cardiac Surgery, Erasme Hospital, University of Brussels (ULB), 
      Route de Lennik, Brussels, Belgium. ahmad_sabry_cts@yahoo.com
FAU - Stefanidis, Constantin
AU  - Stefanidis C
FAU - N'Gatchou, William
AU  - N'Gatchou W
FAU - El Oumeiri, Bachar
AU  - El Oumeiri B
FAU - Jansens, Jean-Luc
AU  - Jansens JL
FAU - De Smet, Jean-Marie
AU  - De Smet JM
FAU - Antoine, Martine
AU  - Antoine M
FAU - De Canniere, Didier
AU  - De Canniere D
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
DEP - 20091208
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Aged
MH  - *Cardiopulmonary Bypass/adverse effects/economics/mortality
MH  - Chi-Square Distribution
MH  - *Coronary Artery Bypass, Off-Pump/adverse effects/economics/mortality
MH  - Coronary Artery Disease/economics/mortality/*surgery
MH  - Cost Savings
MH  - Cost-Benefit Analysis
MH  - Female
MH  - Follow-Up Studies
MH  - Health Care Costs
MH  - Humans
MH  - *Internal Mammary-Coronary Artery Anastomosis/adverse effects/economics/mortality
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Patient Selection
MH  - Prospective Studies
MH  - Recurrence
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2009/12/10 06:00
MHDA- 2010/06/05 06:00
CRDT- 2009/12/10 06:00
PHST- 2009/12/10 06:00 [entrez]
PHST- 2009/12/10 06:00 [pubmed]
PHST- 2010/06/05 06:00 [medline]
AID - icvts.2009.206458 [pii]
AID - 10.1510/icvts.2009.206458 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2010 Mar;10(3):423-7. doi: 
      10.1510/icvts.2009.206458. Epub 2009 Dec 8.