Current Status of Off-Pump Coronary Artery Bypass

Ann Thorac Cardiovasc Surg. 2020 Jun 20;26(3):125-132. doi: 10.5761/atcs.ra.18-00286. Epub 2020 May 29.

Abstract

Purpose: 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).

Methods: Literature consideration was performed, mainly based on observational studies involving large samples and randomized controlled trials (RCTs).

Results: 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.

Conclusion: 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.

Keywords: OPCAB; coronary artery bypass grafting; off-pump coronary artery bypass.

Publication types

  • Review

MeSH terms

  • Coronary Artery Bypass, Off-Pump* / adverse effects
  • Coronary Artery Bypass, Off-Pump* / mortality
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / surgery*
  • Humans
  • Postoperative Complications / mortality
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Vascular Patency