Skip to main content

Advertisement

SpringerLink
Log in

Outcomes of isolated CABG from “OPCAB favor institution” for patients with left ventricular dysfunction

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objectives

Although off-pump coronary artery bypass (OPCAB) has been reported to have better short-term results than on-pump coronary artery bypass (ONCAB) in terms of bleeding and stroke even in patients with cardiac dysfunction, details are unknown. The purpose of this study was to evaluate the outcomes of CABG (coronary artery bypass graft) in patients with low cardiac function based on our treatment policy.

Methods

Retrospectively, we reviewed patients with low ejection fraction (< 35%), who underwent isolated OPCAB or ONCAB between 2013 and 2020 in our institute.

Results

Isolated CABG was performed for 67 patients: 54 OPCABs and 13 ONCABs. In the ONCAB group, six were converted from OPCAB. Patients with AMI, heart failure, liver dysfunction, cardiogenic shock, and ventricular arrhythmia were more common in the ONCAB group. More patients required postoperative mechanical circulatory support in the ONCAB group. Intra-operative blood transfusion, ICU stay, intubation time, and hospital stay were significantly worse in the ONCAB group. Postoperative graft patency was 91.5%. Hospital mortality was 7.5%. Mid-term survival at 30-day, 1-year, and 5-year were 98.5%, 84.6%, and 75.8%, respectively.

Conclusion

In our institute, ONCAB was selected for the patients who could not complete treatment with OPCAB due to poor preoperative circulatory status. Our treatment policy for the patients with impaired cardiac function was acceptable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

CABG:

Coronary artery bypass grafting

OPCAB:

Off-pump coronary artery bypass

ONCAB:

On-pump coronary artery bypass

ICU:

Intensive care unit

EF:

Ejection fraction

IVC:

Inferior vena cava

SVC:

Superior vena cava

CCS:

Canadian cardiovascular society functional classification

HR:

Hazard ratio

CI:

Confidence interval

LAD:

Left anterior descending branch

References

  1. Lamy A, Devereaux PJ, Prabhakaran D, Taggart DP, Hu S, Paolasso E, et al. Effect of off-pump and on-pump coronary-artery bypass grafting at 1 year. New Engl J Med. 2013;368:1179–88.

    Article  CAS  PubMed  Google Scholar 

  2. Yokomaya T, Baumgartner FJ, Ghissari A, Capouya ER, Panagiotides GP, Declusin RJ. Off-pump versus on-pump coronary bypass in high-risk subgroups. Ann Thorac Surg. 2000;70:1546–50.

    Article  Google Scholar 

  3. Al-Ruzzeh S, Nakamura K, Athanasiou T, Modine T, George S, Yacoub M, et al. Does off-pump coronary artery bypass (OPCAB) surgery improve the outcome in high-risk patients? A comparative study of 1398 high-risk patients. Eur J Cardio-thoracic Surg. 2003;23:50–5.

    Article  Google Scholar 

  4. Houlind K, Kjeldsen J, Madsen SN, Rasmussen BS, Holme SJ, Nielsen PH, et al. On-pump versus off-pump coronary artery bypass surgery in elderly patients. Circulation. 2012;20(22):2431–9.

    Article  Google Scholar 

  5. Letsou GV, Wu YX, Grunkemeier G, Rampurwala MM, Kaiser L, Salaskar AL. Off-pump coronary artery bypass and avoidance of hypothermic cardiac arrest improves early left ventricular function in patients with systolic dysfunction. Eur J Cardio-Thoracic Surg. 2011;40:227–32.

    Article  Google Scholar 

  6. Neumann A, Srna-Hiruita L, Detzel H, Popov AF, Kruger T, Vohringer L, et al. Off-pump coronary artery bypass grafting for patients with severely reduced ventricular function—a justified strategy? J Cardiac Surg. 2022;27:7–17.

    Article  Google Scholar 

  7. Darwazah AK, Abu Sham’a RA, Hussein E, Hawari MH, Ismail H. Myocardial revascularization in patients with low ejection fraction<35%: effect of pump technique on early morbidity and mortality. J Cardiac Surg. 2006;21:22–7.

    Article  Google Scholar 

  8. Youn YN, Change BC, Hong YS, Kwak YL, Yoo KJ. Early and mid-term impacts of cardiopulmonary bypass on coronary artery bypass grafting in patients with poor left ventricular dysfunction—a propensity score analysis. Circ J. 2007;71:1387–94.

    Article  PubMed  Google Scholar 

  9. Keeling WB, Williams ML, Slaughter MS, Zhao Y, Puskas JD. Off-pump and on-pump coronary artery revascularization in patients with low ejection fraction: a report from the society of thoracic surgeons national database. Ann Thorac Surg. 2013;96:83–8.

    Article  PubMed  Google Scholar 

  10. Ueki C, Miyata H, Motomura N, Sakaguchi G, Akimoto T, Takamoto S. Off-pump versus on-pump coronary artery bypass grafting in patients with l\left ventricular dysfunction. J Thorac Cardiovasc Surg. 2016;151:1092–8.

    Article  PubMed  Google Scholar 

  11. Magarakis M, Buitrago DH, Macias AE, Tompkins BA, Salerno TA. Off pump coronary artery bypass in patients with and ejection fraction of <20%. What is our strategy? J Card Surg. 2021. https://doi.org/10.1111/jocs.15330.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, IMS Katsushika Heart Center, 3-30-1, Katsushika, Tokyo, 124-0006, Japan

    Yoshifumi Itoda, Kazuki Morooka, Retsu Tateishi, Fumiya Haba, Shunya Ono, Yusuke Tsukioka, Yoshinori Nakahara & Takeyuki Kanemura

Authors
  1. Yoshifumi Itoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazuki Morooka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Retsu Tateishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fumiya Haba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shunya Ono
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yusuke Tsukioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yoshinori Nakahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takeyuki Kanemura
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshifumi Itoda.

Ethics declarations

Conflict of interest

All authors declare no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 13 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Itoda, Y., Morooka, K., Tateishi, R. et al. Outcomes of isolated CABG from “OPCAB favor institution” for patients with left ventricular dysfunction. Gen Thorac Cardiovasc Surg 71, 384–390 (2023). https://doi.org/10.1007/s11748-022-01894-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-022-01894-4

Keywords

Search

Navigation