Thorac Cardiovasc Surg 2022; 70(S 01): S1-S61
DOI: 10.1055/s-0042-1742789
Oral and Short Presentations
Sunday, February 20
CABG: Current Trends

Impact of Off-Pump Coronary Bypass Surgery Experience on Early Postoperative Outcome Results from the E-CABG (European Multicenter Study on Coronary Artery Bypass Grafting)

S. Naito
1   Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH | Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
,
T. J. Demal
1   Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH | Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
,
G. Gatti
2   Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
,
F. Onorati
3   Department of Anesthesiology and Surgery, University of Verona, Verona, Italy
,
F. Santini
4   University of Genova, Genova, Italy
,
H. Reichenspurner
1   Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH | Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
,
B. Sill
1   Herzchirurgie, Universitäres Herz- und Gefäßzentrum UKE Hamburg GmbH | Klinik für Herz- und Gefäßchirurgie, Hamburg, Deutschland
,
F. Biancari
5   University of Turku, Turku, Finland
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    Background: Off-pump coronary artery bypass surgery (OPCAB) is extremely technical demanding. Therefore, we sought to assess the impact of surgical experience on early operative outcome in patients undergoing OPCAB surgery.

    Method: Data from the multicenter E-CABG registry (European Multicenter Study on Coronary Artery Bypass Grafting) conducted between January 2015 and December 2016 at 16 European centers were analyzed. Of 7,352 patients in the E-CABG study, 1,511 patients undergoing OPCAB were included and analyzed retrospectively. We analyzed major complication rates (MACCE: early re-revascularization, stroke, acute kidney injury [AKI] and all causes of death) comparing (1) experienced OPCAB surgeon (cut off: >20 cases per year) (n = 1,180) versus non-experienced (n = 331) and (2) experienced surgeon in high-volume OPCAB center (cut-off: >1/3 OPCAB of total CABG procedures) (n = 998) versus non-high-volume OPCAB center (n = 182).

    Results: In the experienced OPCAB surgeon group, we observed more distal anastomoses (2.4 ± 1.1 vs. 2.1 ± 1.2; p < 0.001) with shorter procedure time (median 205 vs. 245; p < 0.001), a reduction of prolonged inotrope (18 vs. 29%; p < 0.001), and a reduction of the early postoperative percutaneous catheter intervention (PCI) rate (2 vs. 4%; p = 0.033). Furthermore, we observed a trend toward a reduced 30-day mortality (1 vs. 3%; p = 0.091).

    In the high-volume OPCAB centers, significant more distal anastomoses (2.5 ± 1.1 vs. 2.0 ± 0.9; p < 0.001) were performed. Furthermore, we observed trends toward lower mortality (0.9 vs. 2.7%; p = 0.051), less early postoperative PCI procedures (1.5 vs. 3.3%; p = 0.090), and less postoperative AKI (2.9 vs. 5.1%; p = 0.070).

    Conclusion: Not only surgeon experience but also center experience may play an important role on early surgical outcome after OPCAB surgery.


     

    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    03 February 2022

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