Off-pump no-touch technique: 3-year results compared with the SYNTAX trial
Interactive Cardiovascular and Thoracic Surgery , Volume 20 - Issue 5 p. 601- 604
OBJECTIVES A 3-year follow-up of a retrospective, single-centre clinical study of OPCAB (off-pump coronary artery bypass) no-touch technique with arterial composite grafts and an indirect comparison with clinical outcomes of the 3-year follow-up of the SYNTAX trial. METHODS A total of 400 consecutive patients ('all-comers') who underwent OPCAB no-touch coronary surgery. Primary endpoint was 3-year MACCE (major adverse cardiovascular and cerebrovascular events). These results were compared with the randomized arms of the SYNTAX trial. RESULTS The observed 3-year survival was 82.2%. The cumulative 3-year freedom from MACCE was 89.7%. The percentage of MACCE was significantly lower (P < 0.001) in the OPCAB no-touch group (10.3%) compared with both arms of the SYNTAX trial (20.2 and 28.0%, respectively). Repeat revascularization in the OPCAB no-touch group (4.3%) was significantly lower (P < 0.001) compared with both arms of the SYNTAX trial (10.7 and 19.7%, respectively). The percentage of stroke was significantly lower (P = 0.032) in the OPCAB no-touch group compared with the CABG arm in the SYNTAX trial (1.3 vs 3.4%). There was no significant difference of stroke rate between the OPCAB no-touch group and the PCI arm of the SYNTAX trial (1.3 vs 2%, P = 0.347). CONCLUSIONS The results at the 3-year follow-up showed the safety and efficacy of OPCAB no-touch technique. The OPCAB no-touch technique may improve patients' outcome by minimizing the morbidity and the neurological complications. Prospective controlled trials are needed to confirm these results.
|Comparative study, Coronary artery anastomosis, Coronary artery bypass, Internal mammary, Off-pump, Radial artery|
|Interactive Cardiovascular and Thoracic Surgery|
|Organisation||Erasmus MC: University Medical Center Rotterdam|
Arrigoni, S.C, Mecozzi, G, Grandjean, J.G, Hillege, J.L, Kappetein, A.P, & Mariani, M.A. (2015). Off-pump no-touch technique: 3-year results compared with the SYNTAX trial. Interactive Cardiovascular and Thoracic Surgery, 20(5), 601–604. doi:10.1093/icvts/ivv012