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Pamela McDonnell
Office of Public Affairs
NYU School of Medicine
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E-mail: Pamela.McDonnell@med.nyu.edu
NYU Medical Center's Cardiac Surgeons
Prove Decreased Mortality And Stroke for High Risk Patients with Off-Pump Coronary Artery Bypass Grafting
Landmark study on lowering the risk of CABG in high-risk patients reported at the
American Association for Thoracic Surgery meeting
New York, NY - NYU Medical Center’s cardiac surgeons Eugene Grossi, MD, and
Aubrey Galloway, MD, announced new study findings demonstrating significantly
lowered mortality, stroke, and overall risk of complications using off-pump
coronary artery by-pass grafting (OPCAB) in high-risk patients. The
findings were presented today during the Adult Cardiac Surgery Scientific
Session at the 83rd annual meeting of the American Association of Thoracic
Surgeons (AATS) meeting in Boston, MA.
One of the most exciting, and albeit controversial, innovations in coronary
artery bypass grafting (CABG) over the past five years has been the
introduction of “beating heart” or “off-pump”
surgery. During this approach certain areas of the heart are immobilized
with cardiac stabilizers allowing the heart to continue beating during
surgery instead of placing the patient on conventional cardiopulmonary
bypass (CPB).
NYU’s cardiac surgical research team conducted this study over
10 years to access the efficacy of off-pump coronary artery bypass versus
conventional techniques in high-risk patients with severe aortic atherosclerotic
disease.
According to Galloway, Director of Cardiac Surgical Research and co-investigator,
“This is a very positive study for cardiac surgeons and their
patients. Today, we are being asked to treat more patients who are older
and have more co-existing conditions than patients a few years ago.
Cardiac surgery has evolved to address this changing trend, and coronary
artery bypass can now be done in a less traumatic way, minimizing risk
in these older, more severely diseased patients.”
Outcomes data were collected on 5,737 CABG patients, identifying 913
patients as high-risk from advanced aortic atherosclerosis, using intraoperative
transesophageal echocardiography. Of the high-risk patients, 235 underwent
OPCAB, and a propensity case match analysis was conducted comparing
data on 229 high-risk OPCAB patients with 229 high-risk conventional
CPB patients. Results demonstrated a lower hospital mortality (6.5%
vs 11.4%), lower risk of stroke (1.6% vs 5.7%) and better freedom from
all complications (92.2% vs 80. 0%) in the OPCAB patients. Hospital
stay was also 2 days shorter in the OPCAB patients.
“Despite recent advances in angioplasty and stenting, coronary
artery bypass surgery is still necessary for hundreds of thousands of
patients a year and this study demonstrates an approach for making the
surgery safer in elderly, high-risk patients,” says Grossi, principal
investigator of the study.
NYU’s cardiac surgical program is internationally recognized for
both clinical care and innovative research. This study shows the risk-lowering
benefits of newer techniques and evolving technologies in patients requiring
coronary artery bypass grafting.
Founded
in 1917, the American Association for Thoracic Surgery (AATS) is
dedicated to excellence in research, education and innovation in
thoracic surgery. Established by some of the earliest pioneers in
the field of thoracic surgery, the AATS has grown to an international
organization of more than 1100 of the world’s foremost cardiothoracic
surgeons representing 29 countries. More than 2,500 medical professionals
are expected to participate in the AATS 83rd Annual Meeting, May
4-7 in Boston, MA where more than 100 papers will be presented.
The AATS publishes the highly regarded, peer-reviewed Journal
of Thoracic and Cardiovascular Surgery, the official journal
of the Association.
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