Clinical and Radiologic Outcome of Off-Pump Coronary Surgery at 12 Months Follow-Up: A Prospective Randomized Trial

Background After more than a decade of experience with off-pump coronary bypass surgery, still no consensus exists concerning its benefit on clinical outcome compared to the on-pump technique. In this 12-month follow-up, we compare off-pump and on-pump surgery on the appearance of graft patency, myocardial function, and clinical outcome. Methods One hundred twenty patients were randomized to off-pump or on-pump coronary surgery. Angiography was performed intraoperatively, at 3 and 12 months. Global myocardial function was estimated by magnetic resonance imaging (MRI) preoperatively and 12 months postoperatively, as well as functional class and stress testing. Results After 12 months internal mammary artery patency was 94% in the off-pump group and 96% in the on-pump group. Vein graft patency was 80% and 87%, respectively. No statistically significant difference between the two groups existed. There were no differences in exercise capacity improvement and attenuation of symptoms between the groups. Conclusions At 12-months follow-up, off-pump coronary bypass surgery provided the same angiographic graft patency as the on-pump technique. Improvement in functional class and exercise capacity was the same in both groups.