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dc.contributor.authorDhurandhar, V.
dc.contributor.authorSaxena, A.
dc.contributor.authorParikh, R.
dc.contributor.authorVallely, M.
dc.contributor.authorWilson, M.
dc.contributor.authorButcher, J.
dc.contributor.authorBlack, D.
dc.contributor.authorTran, L.
dc.contributor.authorReid, Christopher
dc.contributor.authorBannon, P.
dc.identifier.citationDhurandhar, V. and Saxena, A. and Parikh, R. and Vallely, M. and Wilson, M. and Butcher, J. and Black, D. et al. 2015. 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. Heart, Lung and Circulation. 24 (12): pp. 1225-1232.

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.

dc.publisherElsevier Australia
dc.subjectHigh risk
dc.subjectCoronary artery bypass graft
dc.titleComparison 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
dc.typeJournal Article
dcterms.source.titleHeart, Lung and Circulation
curtin.accessStatusFulltext not available

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