The feasibility and safety of off pump coronary bypass surgery in emergency revascularization

Abstract

Background: The efficacy and safety of off-pump coronary bypass grafting (OPCAB) in emergency revascularization remains controversial despite its widespread use. The aim of our study is to exam the applicability and safety of OPCAB in patients who were indicated for emergency surgery.

Methods: This single center study reviewed indication, operative data, and early and long-term outcomes of 113 patients (age, 66.5±9.3 years; logistic EuroScore, 14.4±13.5) who underwent emergency OPCAB from January 2003 to December 2014 and were followed up (93.8% rate) for a mean 51.1±40.3 (range, 1-135) months.

Results: Emergency OPCAB in the 113 patients studied was associated with

favorable surgical outcomes (on-pump conversion, 4.4%; number of distal

anastomoses per patient, 3.04+0.87; IMA use, 98.2%; and complete

revascularization, 82.3%); in-hospital (mortality, 5.3%; low cardiac output syndrome, 5.3%; stroke, 2.7%; pulmonary complications, 8.8%; renal failure, 11.5%; ventilator use duration, 61.59+126.62 hours; ICU stay, 4.77+6.59 days; and hospital stay, 14.98+9.66 days). The 10-year outcomes (survival, 77.0+0.6%; and major cerebral and cardiovascular events, 52.0+1.6%) were also comparable.

Conclusion: Our study suggests that emergency OPCAB can be performed safely and effectively with improved hospital outcomes and comparable long term results. OPCAB strategy can be considered as a good option in emergency revascularization.