Off-pump versus conventional coronary artery ... - RM Solutions

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Early Mortality• Multi-center (N=126), large cohort of OPCAB (N=11,717), STSriskadjustment• Adjusted OR 0.81 (0.70-0.91)• Biased selection process of patients, mostly single and twovesseldisease OPCAB patientsOff-pump coronary artery bypass grafting decreases riskadjustedmortality and morbidity. Cleveland JC, Shroyer LW,Chen AY, et al. Ann Thorac Surg 2001;72:1282-1289.
Early Mortality• Retrospective analysis of STS database for the year Jan 99-Dec 00• N=17,969 OPCAB patients, (8.8%) of total• Significant survival advantage with OPCAB by risk adjustedmultivariate logistic regression analysis [OR 0.76 (0.68, 0.84)] andconditional logistic regression of propensity matched groups [OR0.83 (0.73, 0.96)]Magee MJ, Coombs LP, Peterson ED and Mack MJ. Circulation2003;108[suppl II]:II9-14
Page 4 and 5: What percentage of surgical revascu
Page 6 and 7: Core CABG procedures are declining
Page 8 and 9: The “Pump Head Paper”• Newman
Page 11 and 12: OPCAB becomes Surgeons’ secret we
Page 13: • Reduced perioperative morbidity
Page 17 and 18: Early Mortality• Randomized trial
Page 19 and 20: Mid-term Mortality• Single center
Page 21 and 22: Perioperative MorbidityOutcome n (N
Page 23 and 24: Early Cognitive Dysfunction• Rand
Page 25 and 26: Renal Failure• No differences in
Page 27 and 28: Completeness of Revascularization -
Page 29 and 30: Completeness of Revascularization -
Page 31 and 32: ROOBY Trial• Primary short term e
Page 33 and 34: ROOBY Trial• Graft Patency:• 64
Page 35 and 36: Discussions• Prospective, randomi
Page 37: Disclosures• I am OPCAB surgeon

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