Off pump coronary artery bypass grafting in EuroSCORE high and low risk patients

Objective: Off pump coronary artery bypass grafting (OPCAB) is claimed to reduce the operative morbidity and mortality in high risk patients. It was the aim of the study to compare the outcome of OPCAB patients classified as high- and low risk according to the EuroSCORE. Methods: Medical records of patients undergoing off pump coronary artery bypass grafting (n=126) at our institution between 1998 and 2001 were retrospectively reviewed. We classified them into two subgroups: low risk (EuroSCORE≦5, n=72, male 58 (81%), female 14 (19%), age 61 (37–78) years) and high risk (EuroSCORE ≫5, n=54, male 32 (59%), female 22 (41%), age 73 (42–83) years). Results: EuroSCORE high risk patients showed significantly higher rates of blood transfusion (70 vs 31%; P≪0.0001), intraaortic balloon pump insertion (16 vs 3%; P=0.013), atrial fibrillation (43 vs 22%; P=0.014), and renal failure (13 vs 3%; P=0.028). ICU length of stay was significantly longer in the high risk group (25 vs 22 h; P=0.002). There was also a higher perioperative mortality in the high risk group (9 vs 0%; P=0.008). Conclusion: From these data we conclude that using off pump coronary artery bypass grafting results as predicted by the EuroSCORE can be achieved. OPCAB is safe for low risk patients. Major complications seem to occur preferentially in the high risk group.