Kuwahara Go, Tashiro Tadashi
Department of Cardiovascular Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Fukuoka, Japan.
Department of General Medical Research Center, Fukuoka University School of Medicine, Fukuoka, Fukuoka, Japan.
Ann Thorac Cardiovasc Surg. 2020 Jun 20;26(3):125-132. doi: 10.5761/atcs.ra.18-00286. Epub 2020 May 29.
Off-pump coronary arterial bypass grafting (OPCAB) has become a common practice for coronary artery bypass grafting (CABG) in Japan, with approximately 65% CABG procedures currently being performed using OPCAB. However, it is unclear whether OPCAB is superior in terms of associated mortality, incidence of complications, graft patency rate, and long-term outcomes compared with conventional CABG (CCABG).
Literature consideration was performed, mainly based on observational studies involving large samples and randomized controlled trials (RCTs).
Many RCTs indicated that the acute-phase and long-term mortality rates were comparable between CCABG and OPCAB or that OPCAB was inferior to CCABG. In contrast, many observational studies indicated that OPCAB was superior to CCABG.
CABG is a delicate procedure, the outcomes of which vary in accordance with the patient's condition as well as the level of expertise of the associated institution and surgeon. In the future, we hope that reports will emerge with excellent results, including long-term results, from Japanese institutions experienced in performing OPCAB.
非体外循环冠状动脉旁路移植术（OPCAB）在日本已成为冠状动脉旁路移植术（CABG）的常见术式，目前约65%的CABG手术采用OPCAB进行。然而，与传统CABG（CCABG）相比，OPCAB在相关死亡率、并发症发生率、移植血管通畅率和长期预后方面是否更具优势尚不清楚。
主要基于涉及大样本的观察性研究和随机对照试验（RCT）进行文献综述。
许多RCT表明，CCABG和OPCAB的急性期和长期死亡率相当，或者OPCAB不如CCABG。相比之下，许多观察性研究表明OPCAB优于CCABG。
CABG是一项精细的手术，其结果会因患者病情以及相关机构和外科医生的专业水平而有所不同。未来，我们希望日本有经验进行OPCAB的机构能发表包括长期结果在内的出色报告。
