The individual contribution of the specific injuring mechanisms surgical trauma, extracorporeal circulation, and ischemia/reperfusion to clinical outcome in coronary revascularisation remains to be elucidated. The effect of these factors is analyzed in this randomized clinical trial by comparing the 3 surgical approaches: Conventional Coronary Artery Bypass Grafting (CCAB), with extracorporeal circulation and cardioplegic arrest; Off-Pump Coronary Artery Bypass Grafting (OPCAB), avoids extracorporeal circulation and global myocardial ischemia; and Pump-Assisted Coronary Artery Bypass Grafting (PACAB), with an unloaded and beating heart. The hypothesis addressed by the study is that the surgical invasiveness increases in the order: OPCAB, PACAB, CCAB.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
616
Coronary artery bypass grafting with extracorporeal circulation and cardioplegic arrest
Coronary artery bypass grafting without extracorporeal circulation or global myocardial ischemia
Coronary artery bypass grafting with a beating but unloaded heart by using extracorporeal circulation
Heart Center Coswig, Department of Cardiothoracic and Vascular Surgery
Coswig, Germany
Martin-Luther-University Halle-Wittenberg, Department of Cardiothoracic Surgery
Halle, Germany
All cause mortality
Time frame: 1, 6, 12, 24, 48 month
Myocardial infarction
Time frame: 1, 6, 12, 24, 48 month
Stroke
Time frame: 1, 6, 12, 24, 48 month
Low-output syndrome
Time frame: in hospital
duration of ventilation >= 24h
Time frame: in hospital
New requirement of hemodialysis
Time frame: in hospital
Completeness of revascularization
Time frame: in hospital
Re-revascularization of the target vessel (PCI and/or CABG)
Time frame: 1, 6, 12, 24, 48 month
Resource use (operative time, duration of stay in the intensive care unit, total hospital stay)
Time frame: in hospital
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