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
dx.doi.org/10.1093/icvts/ivv012, hdl.handle.net/1765/88946
Interactive Cardiovascular and Thoracic Surgery
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