Study Design and Subjects
This was a retrospective, matched cohort study using data from the
Hua-Shan Cardiac Surgery Registry. The consecutive coronary artery
disease patients aged ≥ 18 years who were underwent OPCAB procedures
between 01 January 2016 and 31 December 2019 were enrolled. OPCAB were
performed by one fully trained cardiac surgeon team, whose members had
already performed a minimum of 50 off-pump operations. To be included,
eligible patients had to have continuous medical record during
preoperative, intraoperative and postoperative period. Patients were
excluded if they were unable to understand given information or were
reluctant to participate, had resection of ventricular aneurysm or re-do
cardiac surgery, were technically not feasible for OPCAB, and had other
logistic reasons that made routine follow up impossible.
Preoperatively, patient demographics were recorded. Patients were
divided into two cohorts determined by left ventricular ejection
fraction using the transthoracic echocardiogram: the left ventricular
dysfunction (LVD) cohort consisted of those who had LVEF<50%,
and the normal left ventricular function (NLVF) cohort included patients
had LVEF≥50%. Intraoperative variables were documented for all cohorts.
All the eligible patients were periodically followed by on-site visit,
telephone call or mailed questionnaire up to 31 June 2020. During
on-site follow up, the computed tomographic angiography (CTA) or digital
subtraction angiography (DSA) were used to assess the graft and
echocardiography were used to measure the ventricular chamber size and
LVEF. The blood pressure, lipid profile and blood glucose level of
patients, which were directly associated with middle and long-term
outcomes of grafts, were monitored. Patients reported events of clinical
interest were collected and assessed systematically during follow up
stages.
The present study was approved by the Ethic Committee of Hua Shan
Hospital and conducted in concordance with Good Clinical Practice.