Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database
Background: The elderly population (age >70 years) incurs greater mortality and morbidity following CABG. OPCAB may mitigate these otucomes. A retrospective analysis of the results of OPCAB in this population was performed. Methods: We reviewed the Australian and New Zealand Society of Cardiac an...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal Article |
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Elsevier Australia
2015
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| Online Access: | http://hdl.handle.net/20.500.11937/14777 |
| _version_ | 1848748713915187200 |
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| author | Dhurandhar, V. Saxena, A. Parikh, R. Vallely, M. Wilson, M. Butcher, J. Black, D. Tran, L. Reid, Christopher Bannon, P. |
| author_facet | Dhurandhar, V. Saxena, A. Parikh, R. Vallely, M. Wilson, M. Butcher, J. Black, D. Tran, L. Reid, Christopher Bannon, P. |
| author_sort | Dhurandhar, V. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: The elderly population (age >70 years) incurs greater mortality and morbidity following CABG. OPCAB may mitigate these otucomes. A retrospective analysis of the results of OPCAB in this population was performed. Methods: We reviewed the Australian and New Zealand Society of Cardiac and Thoracic Surgeons’ (ANZSCTS) database for elderly patients (n=12697) undergoing isolated CABG surgery and compared the ONCAB (n=11676) with OPCAB (n=1021) technique. Preoperative and intraoperative risk factors, and postoperative outcomes were analysed. Survival analyses was performed after cross-matching the database with the national death registry to identify long-term mortality. Results: High-risk patients were more prevalent in the ONCAB group (p<0.05). OPCAB patients received fewer distal anastomoses than ONCAB patients (2.4±1.1 vs 3.3±1.0, p<0.001). Thirty-day mortality and stroke rates between OPCAB and ONCAB were not significantly different (2% vs 2.5% and 1.1% vs 1.8%, respectively). There was a non-significant trend towards improved 10-year survival in OPCAB patients using multivariate analysis (78.8% vs. 73.3%, p=0.076, HR 0.83; 95% CI 0.67-1.02). Conclusions: Mortality and stroke rates following CABG surgery are extremely low in the elderly suggesting that surgery is a safe management option for coronary artery disease in this population. OPCAB did not offer a significant advantage over ONCAB with regards to 30-day mortality, stroke and long-term survival. Further prospective randomised trials will be necessary to clarify risks or benefits in the elderly. |
| first_indexed | 2025-11-14T07:09:25Z |
| format | Journal Article |
| id | curtin-20.500.11937-14777 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:09:25Z |
| publishDate | 2015 |
| publisher | Elsevier Australia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-147772017-09-13T15:59:27Z Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database Dhurandhar, V. Saxena, A. Parikh, R. Vallely, M. Wilson, M. Butcher, J. Black, D. Tran, L. Reid, Christopher Bannon, P. High risk On-pump Elderly Off-pump Coronary artery bypass graft Background: The elderly population (age >70 years) incurs greater mortality and morbidity following CABG. OPCAB may mitigate these otucomes. A retrospective analysis of the results of OPCAB in this population was performed. Methods: We reviewed the Australian and New Zealand Society of Cardiac and Thoracic Surgeons’ (ANZSCTS) database for elderly patients (n=12697) undergoing isolated CABG surgery and compared the ONCAB (n=11676) with OPCAB (n=1021) technique. Preoperative and intraoperative risk factors, and postoperative outcomes were analysed. Survival analyses was performed after cross-matching the database with the national death registry to identify long-term mortality. Results: High-risk patients were more prevalent in the ONCAB group (p<0.05). OPCAB patients received fewer distal anastomoses than ONCAB patients (2.4±1.1 vs 3.3±1.0, p<0.001). Thirty-day mortality and stroke rates between OPCAB and ONCAB were not significantly different (2% vs 2.5% and 1.1% vs 1.8%, respectively). There was a non-significant trend towards improved 10-year survival in OPCAB patients using multivariate analysis (78.8% vs. 73.3%, p=0.076, HR 0.83; 95% CI 0.67-1.02). Conclusions: Mortality and stroke rates following CABG surgery are extremely low in the elderly suggesting that surgery is a safe management option for coronary artery disease in this population. OPCAB did not offer a significant advantage over ONCAB with regards to 30-day mortality, stroke and long-term survival. Further prospective randomised trials will be necessary to clarify risks or benefits in the elderly. 2015 Journal Article http://hdl.handle.net/20.500.11937/14777 10.1016/j.hlc.2015.04.162 Elsevier Australia restricted |
| spellingShingle | High risk On-pump Elderly Off-pump Coronary artery bypass graft Dhurandhar, V. Saxena, A. Parikh, R. Vallely, M. Wilson, M. Butcher, J. Black, D. Tran, L. Reid, Christopher Bannon, P. Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database |
| title | Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database |
| title_full | Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database |
| title_fullStr | Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database |
| title_full_unstemmed | Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database |
| title_short | Comparison of the Safety and Efficacy of On-Pump (ONCAB) versus Off-Pump (OPCAB) Coronary Artery Bypass Graft Surgery in the Elderly: A Review of the ANZSCTS database |
| title_sort | comparison of the safety and efficacy of on-pump (oncab) versus off-pump (opcab) coronary artery bypass graft surgery in the elderly: a review of the anzscts database |
| topic | High risk On-pump Elderly Off-pump Coronary artery bypass graft |
| url | http://hdl.handle.net/20.500.11937/14777 |