Department for Cardiac surgery, Clinical Center of Serbia, Koste Todorovica 8, 11000, Belgrade, Serbia.
Department for Anesthesiology and Intensive care, Clinical Center of Serbia, Koste Todorovica 8, 11000, Belgrade, Serbia.
Sci Rep. 2019 Jun 12;9(1):8567. doi: 10.1038/s41598-019-45093-3.
Coronary artery bypass grafting (CABG) remains the most frequent surgery in the practice of an adult cardiac surgeon and the most frequently performed cardiac surgical procedure worldwide. Despite the ongoing debates regarding the superiority or inferiority of off-pump coronary artery bypass grafting, it still comprises 15-30% of all CABG cases varying in different national registries. We performed a propensity matched study of 302 consecutive CABG patients,143 off -pump cases performed by the four experienced off-pump surgeons and the on-pump CABG cases performed by those surgeons and four other experienced coronary surgeons. The five year follow up was performed and data collected comprised of mortality, rehospitalization due to cardiac origin, repeated revascularization, myocardial infarction and cerebrovascular accident. Overall, the off-pump group of patients had a higher risk profile than the patients in the on-pump group. After matching, fewer differences were found between the groups. Propensity score matching analysis showed no difference in long-term survival as well as MACCE and repeated revascularization. The higher risk profile of the patients subjected to OPCAB and the comparable survival to lower risk CPB patients in this series indicate that in experienced hands, OPCAB is a valuable option in this important subgroup of patients.
冠状动脉旁路移植术（CABG）仍然是成人心脏外科医生实践中最常见的手术，也是全球最常进行的心脏外科手术。尽管关于非体外循环冠状动脉旁路移植术的优越性或劣性仍在争论中，但它仍然占所有 CABG 病例的 15-30%，在不同的国家注册中心有所不同。我们对 302 例连续 CABG 患者进行了倾向评分匹配研究，其中 143 例非体外循环 CABG 由 4 名经验丰富的非体外循环外科医生进行，体外循环 CABG 由这些外科医生和其他 4 名经验丰富的冠状动脉外科医生进行。进行了 5 年的随访，并收集了死亡率、因心脏原因再次住院、再次血运重建、心肌梗死和脑血管意外的数据。总的来说，非体外循环组患者的风险状况高于体外循环组患者。匹配后，两组之间的差异较小。倾向评分匹配分析显示，长期生存率以及 MACCE 和再次血运重建无差异。在本系列中，接受 OPCAB 的患者风险状况较高，与低风险 CPB 患者的生存情况相当，这表明在有经验的医生手中，OPCAB 是该重要亚组患者的一个有价值的选择。
