Off-pump coronary artery bypass grafting
Institute for Clinical Systems Improvement
Record ID 32003000562
English
Authors' objectives:
This review aims to assess the available evidence on the effectiveness of off-pump coronary artery bypass grafting.
Authors' recommendations:
With regard to off-pump coronary artery bypass grafting (CABG) the ICSI Technology Assessment Committee finds:
The potential uses for and technology of off-pump CABG continue to evolve. There is a steep learning curve for the procedure and it should be applied carefully with rigorous assessment of graft patency and objective follow-up for the first part of a surgeons experience. Surgeons should also have experience and competence in on-pump CABG prior to doing off-pump CABG. Under these conditions, off-pump CABG is acceptably safe.
Short-term studies have shown that off-pump CABG may require fewer blood transfusions, decrease patient atrial fibrillation, and decrease hospital length of stay as compared to on-pump CABG (Conclusion Grade II). However, one potential disadvantage of off-pump is that for the novice off-pump surgeon there may be a reduced number of grafts that can be performed during surgery as compared to on-pump CABG. Also, the effect of off-pump CABG on graft patency and completeness of revascularization remains uncertain.
Long-term randomized controlled trials have not been done and these clinical and angiographic studies would be helpful in order to determine long-term neurological outcome, long-term graft patency, and completeness of revascularization.
Given the limited data and evolution of the procedure, off-pump CABG, in the hands of an experienced surgeon and dedicated team, may provide an effective option for appropriately selected patients.
Authors' methods:
Review
Details
Project Status:
Completed
URL for project:
http://www.icsi.org/index.asp
Year Published:
2003
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Coronary Artery Bypass
Contact
Organisation Name:
Institute for Clinical Systems Improvement
Contact Address:
8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675
Contact Name:
icsi.info@icsi.org
Contact Email:
icsi.info@icsi.org
Copyright:
Institute for Clinical Systems Improvement (ICSI)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.