ABSTRACT 32

CORONARY ARTERY BYPASS IN THE CURRENT ERA WITH AND WITHOUT CARDIOPULMONARY BYPASS

Mario Chiavarelli, Konstantin Tarashansky, Michael Wolfeld, Samantha Golden, Mario Sabado, Israel Jacobowitz. SUNY-UHB and Maimonides Medical Center, Brooklyn, NY

Off-pump CABG (OFF-CABG) is expected to decrease mortality and morbidity associated to the use of cardiopulmonary bypass (ON-CABG). Early mortality and stroke prevalence were assessed retrospectively.

1010 consecutive patients underwent isolated CABG from January 1998 through September 2000. Probability of in-hospital death was calculated according to the model developed by the New York State Department of Health. Data were examined by contingency tables and t-test.

791 patients (78%) underwent OFF-CABG. In-hospital mortality was 2.6% (CI 2.1-3.4) for OFF-CABG and 5.0% (CI 3.5-7.0) for ON-CABG (χ²=3.13; p=0.077). Probability of in-hospital death was 3.6% (SD 5.2) for OFF-CABG and 3.9% (SD 7.8) for ON-CABG (t=0.632; p=0.527). Stroke prevalence was 1.1% (CI 0.8-1.7) for OFF-CABG and 0.9% (CI 0.3-2.2) for ON-CABG (χ²=0.08; p=0.777).

OFF-CABG offers a better early survival even if the difference does not reach statistical significance. This could not be explained by preoperative selection since  expected mortality was not different. Stroke prevalence is lower than in previous studies, and a larger population sample might be needed to show significant differences.