Monday, 1 September 2008 - European Heart Journal

284 Optimisation of techniques and adjunct therapy in cardiac surgery
dure. Demographic profiles, operative data, long term survival and quality of life
by the Short Form 36 Health Survey questionnaire were analysed.
The 30 day mortality was 14.7% in the reoperation group and 8.5% (p=0.43)
in the control group. Average time between previous operation and reoperation
was 10.8±5.6 (range 1.7–30.6 years). Actuarial survival at 1, 3 and 6
years was 77.2±5%, 58.3±6.3% and 36.3±7.8% for patients with reoperation
and 71±5.5%, 58.3±6.3% and 30±8.1% for matched patients with primary cardiac
surgery (p=0.68) (figure). No significant differences regarding the physical
(40.7±9.4 vs. 39.1±10, p=0.55) and the mental health summarized-score
(51.9±10.9 vs. 48±12.9, p=0.24) of the SF-36 were found between groups.
Octogenarians exhibit a similar mortality, long-term survival and quality of life following
primary and redo cardiac surgery. Therefore, this kind of surgery should
not be reserved for younger patients alone.
P1885 Mass-III: a randomized study comparing on-pump and
off-pump coronary artery bypass graft surgery: 3-year
results
N.H. Lopes1 , A.F.T. Gois2 ,F.S.Paulitsch2 , C.L. Garzillo2 ,L.Dallan2 ,
L.A.M. Cesar2 , N.A.G. Stolf2 , W. Hueb2 on behalf of MASS. 1Heart Institute - INCOR, Chronic Coronary Disease Department, Sao Paulo, Brazil;
2Heart Institute, Sao Paulo, Brazil
Introduction: In recent decades, concern has been increasing regarding reducing
mortality and morbidity related to coronary artery bypass graft (CABG)
surgery, particularly related to on-pump procedures. In this scenario, the development
of off-pump techniques might provide advantages.
Objectives: We compared the results of on-pump and off-pump procedures, regarding
data during surgery, clinical evolution after surgery, and mortality and
morbidity at 3-year follow-up.
Methods: Patients with multivessel chronic coronary artery disease (CAD) and
preserved left ventricular function who needed a CABG procedure and were suitable,
according to surgeon’s assessment, for either on-pump or off-pump revascularization
techniques were randomized and followed up. The duration of the
surgery and need of a ventilator, intensive care unit (ICU) and hospital stay, clinical
problems, and need of a blood transfusion were analyzed. The primary endpoints
were cardiac death, myocardial infarction, and refractory angina requiring
a new intervention.
Results: 279 patients were randomized: 140 to on-pump and 139 to off-pump
CABG. Baseline profiles were similar between the groups. Of those in the offpump
group, a significant reduction occurred in the duration of surgery (4,08h vs.
5,04h, p