Off-Pump versus On-Pump Coronary Bypass Surgery

To the Editor: In the article by Khan et al. (Jan. 1 issue), 1 the conclusion regarding the inferiority of graft patency in patients who have undergone off-pump bypass surgery is premature. Before initiation of the study, each of the two participating surgeons had performed, on average, only 49 off-pump graft procedures, and they performed a total of only 75 such procedures (in 27 patients) during the trial. The study identified disparate reductions in overall patency for grafts in the right-coronary-artery distribution and for those involving radial-artery conduits, as compared with previously published results. 2 There is a direct correlation between the . . .