Off-pump Coronary Artery Bypass Grafting in Elderly and High-risk Patients - A Review

Heart Lung and Circulation

Volumn 20, Issue 11, 2011, Pages 694-703

  Cooper, Edward A ^a,b,c   Edelman, J James B ^a,b,c   Wilson, Michael K ^a,b,c   Bannon, Paul G ^a,b,c   Vallely, Michael P ^a,b,c  

^a ROYAL PRINCE ALFRED HOSPITAL   (Australia)

^b The Baird Institute   (Australia)

^c UNIVERSITY OF SYDNEY   (Australia)

Author keywords

Aged; Aged, 80 and over; Comorbidity; Coronary artery bypass, Off pump; High risk patients

Indexed keywords

ANTIANGINA PECTORIS AGENT; ANTITHROMBOCYTIC AGENT; CREATININE; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR;

AGED; BARE METAL STENT; CARDIOPULMONARY BYPASS; CHRONIC OBSTRUCTIVE LUNG DISEASE; COMORBIDITY; CORONARY ARTERY BYPASS SURGERY; CORONARY ARTERY DISEASE; CREATININE BLOOD LEVEL; DIABETES MELLITUS; DISEASE ASSOCIATION; DRUG ELUTING STENT; GERIATRIC PATIENT; HEART LEFT VENTRICLE EJECTION FRACTION; HEART LEFT VENTRICLE FAILURE; HEART MUSCLE REVASCULARIZATION; HIGH RISK PATIENT; HUMAN; IN-STENT RESTENOSIS; KIDNEY FAILURE; LEFT CORONARY ARTERY; MORTALITY; OFF PUMP CORONARY SURGERY; PERCUTANEOUS CORONARY INTERVENTION; PERIPHERAL VASCULAR DISEASE; PRIORITY JOURNAL; REVIEW; STERNOTOMY; SURVIVAL TIME;

AGED; AGED, 80 AND OVER; CLINICAL TRIALS AS TOPIC; CORONARY ARTERY BYPASS, OFF-PUMP; CORONARY ARTERY DISEASE; DIABETES MELLITUS; FEMALE; HEALTH SERVICES FOR THE AGED; HUMANS; MALE; PERIPHERAL VASCULAR DISEASES; PULMONARY DISEASE, CHRONIC OBSTRUCTIVE; RENAL INSUFFICIENCY; RISK FACTORS; STROKE VOLUME;

EID: 80054090721     PISSN: 14439506     EISSN: 14442892     Source Type: Journal    
DOI: 10.1016/j.hlc.2011.07.006     Document Type: Review

References (85)

1. Goyal S., Henry M., Mohajeri M. Outcome and quality of life after cardiac surgery in octogenarians. ANZ Journal of Surgery 2005, 75(6):429-435.
2. Kurlansky P.A., Williams D.B., Traad E.A., Zucker M., Ebra G. Eighteen-year follow-up demonstrates prolonged survival and enhanced quality of life for octogenarians after coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 2011, 141(2):394-399.
3. Hewitt T.D., Santa Maria P.L., Alvarez J.M. Cardiac surgery in Australian octogenarians: 1996-2001. ANZ Journal of Surgery 2003, 73(9):749-754.
4. Yokoyama T., Baumgartner F.J., Gheissari A., Capouya E.R., Panagiotides G.P., Declusin R.J. Off-pump versus on-pump coronary bypass in high-risk subgroups. The Annals of Thoracic Surgery 2000, 70:1546-1550.
5. Vallely M.P., Bannon P.G., Bayfield M.S., Hughes C.F., Kritharides L. Quantitative and temporal differences in coagulation, fibrinolysis and platelet activation after on-pump and off-pump coronary artery bypass surgery. Heart, Lung and Circulation 2009, 18(2):123-130.
6. Lev-Ran O., Loberman D., Matsa M., Pevni D., Nesher N., Mohr R., et al. Reduced strokes in the elderly: the benefits of untouched aorta off-pump coronary surgery. The Annals of Thoracic Surgery 2004, 77:102-107.
7. Edelman J.J., Yan T.D., Padang R., Bannon P.G. Off-pump coronary artery bypass surgery versus percutaneous coronary intervention: a meta-analysis of randomized and nonrandomized studies. The Annals of Thoracic Surgery 2010, 90(4):1384-1390.
8. Al-Ruzzeh S., Nakamura K., Athanasiou T., Modine T., George S., Yacoub M., et al. Does off-pump coronary artery bypass (OPCAB) surgery improve the outcome in high-risk patients? A comparative study of 1398 high-risk patients. European Journal of Cardio-thoracic Surgery 2003, 23(1):50-55.
9. Puskas J.D., Thourani V.H., Kilgo P., Cooper W., Vassiliades T., Vega D., et al. Off-pump coronary artery bypass disproportionately benefits high-risk patients. The Annals of Thoracic Surgery 2009, 88(4):1142-1147.
10. Carrier M., Perrault L.P., Jeanmart H., Martineau R. Randomized trial comparing off-pump to on-pump coronary artery bypass grafting in high-risk patients. The Heart Surgery Forum 2003, 6(6):E89-E92.
11. Moller C.H., Perko M.J., Lund J.T., Andersen L.W., Kelbaek H., Madsen J.K., et al. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary artery bypass surgery: The Best Bypass Surgery Trial. Circulation 2010, 121:498-504.
12. Graham M.M., Ghali W.A., Faris P.D., Galbraith D., Norris C.M., Knudtson M.L., et al. Survival after coronary revascularization in the elderly. Circulation 2002, 105(20):2378-2384.
13. Kaiser C., Kuster G.M., Erne P., Amann W., Naegeli B., Osswald S., et al. Risks and benefits of optimised medical and revascularisation therapy in elderly patients with angina - on-treatment analysis of the TIME trial. European Heart Journal 2004, 25(12):1036-1042.
14. Long-term outcome in elderly patients with chronic angina managed invasively versus by optimized medical therapy: four year follow-up of the randomized trial of invasive versus medical therapy in elderly patients (TIME). Circulation 2004, 110(10):1213-1218. The TIME Investigators.
15. Dacey L.J., Likosky D.S., Ryan T.J., Robb J.F., Quinn R.D., DeVries J.T., et al. Long-term survival after surgery versus percutaneous intervention in octogenarians with multivessel coronary disease. The Annals of Thoracic Surgery 2007, 84:1904-1911.
16. McKellar S.H., Brown M.L., Frye R.L., Schaff H.V., Sundt T.M. Comparison of coronary revascularization procedures in octogenarians: a systematic review and meta-analysis. Nature Clinical Practice Cardiovascular Medicine 2008, 5(11):738-746.
17. Demaria R., Carrier M., Fortier S., Martineau R., Fortier A., Cartier R., et al. Reduced mortality and strokes with off-pump coronary artery bypass grafting surgery in octogenarians. Circulation 2002, 106(12):I-5-I-10.
18. Ricci M., Karamanoukian H.L., Abraham R., Von Fricken K., D'Ancona G., Choi S., et al. Stroke in octogenarians undergoing coronary artery surgery with and without cardiopulmonary bypass. The Annals of Thoracic Surgery 2000, 69(5):1471-1475.
19. LePar D.J., Bhamidipati C.M., Reece T.B., Cleveland J.C., Kron I.L., Ailawadi G. Is off-pump coronary artery bypass grafting superior to conventional bypass in octogenarians?. The Journal of Thoracic and Cardiovascular Surgery 2011, 141(1):81-90.
20. Gongora E., Sundt T.M. Role of surgical revascularization in diabetic patients with coronary artery disease. Expert Review of Cardiovascular Therapy 2005, 3(2):249-260.
21. Stettler C., Alleman S., Wandel S., Kastrati A., Morice M.C., Schomig A., et al. Drug eluting and bare metal stents in people with and without diabetes: collaborative network meta-analysis. British Medical Journal 2008, 337. a1331.
22. Moussa I., Leon M.B., Baim D.S., O'Neill W.W., Popma J.J., Buchbinder M., et al. Impact of sirolimus-eluting stents on outcome in diabetic patients: a SIRIUS (SIRoLLmUS-coated BxVelocity balloon-expandable stent in treatment of patients with de novo coronary artery lesions) substudy. Circulation 2004, 109(19):2273-2278.
23. Influence of diabetes on 5-year mortality and morbidity in a randomized trial comparing CABG and PTCA in patients with multivessel disease: the Bypass Angioplasty Revascularization Investigation (BARI). Circulation 1997, 96(16):1761-1769.
24. Frye R.L., August P., Brooks M.M., Hardison R.M., Kelsey S.F., et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. The New England Journal of Medicine 2009, 360(24):2503-2515. BARI 2D Study Group.
25. Banning A.P., Westaby S., Morice M.C., Kappetein A.P., Mohr F.W., Berti S., et al. Diabetic and nondiabetic patients with left main and/or 3-vessel coronary artery disease: comparison of outcomes with cardiac surgery and paclitaxel-eluting stents. Journal of the American College of Cardiology 2010, 55(11):1067-1075.
26. Kappetein AP, Feldman TE, Mack MJ, Morice MC, Holmes Jr DR, Stahle E, et al. Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease: 3-year follow-up of the SYNTAX trial. European Heart Journal 2011;First published online June 22, 2011, doi:10.1093/eurheartj/ehr213.
27. Hlatky M.A., Boothroyd D.B., Boersma E., Booth J., Brooks M.M., Carrie D., et al. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaboartive analysis of individual patient data from ten randomised trials. The Lancet 2009, 373(9670):1190-1197.
28. Magee M.J., Dewey T.M., Acuff T., Edgerton J.R., Hebeler J.F., Prince S.L., et al. Influence of diabetes on mortality and morbidity: off-pump coronary artery bypass grafting versus coronary artery bypass grafting with cardiopulmonary bypass. The Annals of Thoracic Surgery 2001, 72(3):776-781.
29. Srinivasan A.K., Grayson A.D., Fabri B.M. On-pump versus off-pump coronary artery bypass grafting in diabetic patients: a propensity score analysis. The Annals of Thoracic Surgery 2004, 78:1604-1609.
30. Hall W.D. Abnormalities of kidney function as a cause and a consequence of cardiovascular disease. The American Journal of the Medical Sciences 1999, 317(3):176-182.
31. Shulman N.B., Ford C.E., Hall W., Blaufox M.D., Simon D. Prognostic value of sercum creatinine and effect of treatment of hypertension on renal function: results from the Hypertension Detection and Follow-up Program. Hypertension 1989, 13(5):I-80-I-93.
32. Lopes N.H., da Silva Paulitsch F., Pereira A., Garzillo C.L., Ferreira J.F., Stolf N., et al. Mild chronic kidney dysfunction and treatment strategies for stable coronary artery disease. The Journal of Thoracic and Cardiovascular Surgery 2009, 137(6):1443-1449.
33. Chukwuemeka A., Weisel A., Maganti M., Nette A.F., Wijeysundera D.N., Beattie W.S., et al. Renal dysfunction in high-risk patients after on-pump and off-pump coronary artery bypass surgery: a propensity score analysis. The Annals of Thoracic Surgery 2005, 80(6):2148-2153.
34. Hilberman M., Derby G.C., Spencer R.J., Stinson E.B. Sequential pathophysiological changes characterizing the progression from renal dysfunction to acute renal failure following cardiac operation. The Journal of Thoracic and Cardiovascular Surgery 1980, 79:838-844.
35. Chertow G.M., Levy E.M., Hammermesiter K.E., Grover F., Daley J. Independent association between acute renal failure and mortality following cardiac surgery. The American Journal of Medicine 1998, 104(4):343-348.
36. Sajja L.R., Mannam G., Chakravarthi R.M., Sompalli S., Naidu S.K., Somaraju B., et al. Coronary artery bypass grafting with or without cardiopulmonary bypass in patients with preoperative non-dialysis dependent renal insufficiency: a randomized study. The Journal of Thoracic and Cardiovascular Surgery 2007, 133(2):378-388.
37. Beauford R.B., Saunders C.R., Niemeier L.A., Lunceford T.A., Karanam R., Prendergast T.W., et al. Is off-pump revascularization better for patients with non-dialysis-dependent renal insufficiency?. The Heart Surgery Forum 2004, 7(2):E141-E146.
38. Gamoso M.G., Phillips-Bute B., Landolfo K.P., Newman M.F., Stafford-Smith M. Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction. Anesthesia and Analgesia 2000, 91(5):1080-1084.
39. Schwann N.M., Horrow J.C., Strong M.D., Chamchad D., Guerraty A., Wechsler A.S. Does off pump coronary artery bypass reduce the incidence of clinically evident renal dysfunction after multivessel myocardial revascularization?. Anesthesia and Analgesia 2004, 99(4):959-964.
40. Emond M., Mock M.B., Davis K.B., Fisher L.D., Holmes D.R., Chaitman B.R., et al. Long-term survival of medically treated patients in the Coronary Artery Surgery Study (CASS) registry. Circulation 1994, 90(6):2645-2657.
41. Califf R.M., Harrell F.E., Lee K.L., Rankin J.S., Hlatky M.A., Mark D.B., et al. The evolution of medical and surgical therapy for coronary artery disease: a 15 year perspective. The Journal of the American Medical Association 1989, 261(14):2077-2086.
42. Franciosa J.A., Wilen M., Ziesche S., Cohn J.N. Survival in men with severe chronic left ventricular failure due to either coronary heart disease or idiopathic dilated cardiomyopathy. The American Journal of Cardiology 1983, 51(5):831-836.
43. Allman K.C., Shaw L.J., Hachamovitch R., Udelson J.E. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. Journal of American College of Cardiology 2002, 39(7):1151-1158.
44. Wijns W., Kolh P., Danchin N., Di Mario C., Falk V., Folliguet T., et al. Guidelines on myocardial revascularization. European Heart Journal 2010, 31:2501-2555.
45. Vahanian A., Baumgartner H., Bax J., Butchart E., Dion R., Filippatos G., et al. Guidelines on the management of valvular heart disease: the task force on the management of valvular heart disease of the European Society of Cardiology. European Heart Journal 2007, 28(2):230-268.
46. Sedlis S.P., Ramanathan K.B., Morrison D.A., Sethi G., Sacks J. Outcome of percutaneous coronary intervention versus coronary bypass grafting for patients with low left ventricular ejection fractions, unstable angina pectoris and risk factors for adverse outcomes with bypass (the AWESOME randomized trial and registry). The American Journal of Cardiology 2004, 94(1):118-120.
47. Toda K., MacKenzie K., Mehra M.R., DiCorte C.J., Davis J.E., McFadden P.M., et al. Revascularization in severe ventricular dysfunction (15%
48. Masoumi M., Saidi M.R., Rostami F., Sepahi H., Roushani D. Off-pump coronary artery bypass grafting in left ventricular dysfunction. Asian Cardiovascular and Thoracic Annals 2008, 16(1):16-20.
49. Meharwal Z.S., Trehan N. Off-pump coronary artery bypass grafting in patients with left ventricular dysfunction. Heart Surgery Forum 2002, 5(1):41-45.
50. Azarfarin R., Pourafkari L., Parvizi R., Alizadehasl A., Mahmoodian R. Off-pump coronary artery bypass surgery in severe left ventricular dysfunction. Asian Cardiovascular and Thoracic Annals 2010, 18:44-48.
51. Darwazah A.K., Abu Sham'a R.A., Hussein E., Hawari M.H., Ismail H. Myocardial revascularization in patients with low ejection fraction <35%: effect of pump technique on early morbidity and mortality. Journal of Cardiac Surgery 2006, 21(1):22-27.
52. Casser A., Poldermans D., Rihal C.S., Gersch B.J. The management of combined coronary artery disease and peripheral vascular disease. European Heart Journal 2010, 31(13):1565-1572.
53. Steg G., Bhatt D.L., Wilson P.W.F., D'Agostino R., Ohman M., Rother J., et al. for the REACH registry investigators one-year cardiovascular event rates in outpatients with atherothrombosis. The Journal of the American Medical Association 2007, 297(11):1197-1206.
54. Eagle K.A., Rihal C.S., Foster E.D., Mickel M.C., Gersch B.J. for the Coronary Artery Surgery Study (CASS) investigators. Long-term survival in patients with coronary artery disease: importance of peripheral vascular disease. Journal of the American College of Cardiology 1994, 23(5):1091-1095.
55. Minakata K., Konishi Y., Matsumoto M., Aota M., Sugimoto A., Nonaka M., et al. Influence of peripheral vascular occlusive disease on the morbidity and mortality of coronary artery bypass grafting. Japanese Circulation Journal 2000, 64(12):905-908.
56. Collison T., Smith J.M., Engel A.M. Peripheral vascular disease and outcomes following coronary artery bypass graft surgery. Archives of Surgery 2006, 141(12):1214-1218.
57. Birkmeyer J.D., Quinton H.B., O'Connor N.J., McDaniel M.D., Leavitt B.J., Charlesworth D.C., et al. The effect of peripheral vascular disease on long-term mortality after coronary artery bypass surgery. Archives of Surgery 1996, 131(3):316-321.
58. Saw J., Bhatt D.L., Moliterno D.J., Brener S.J., Steinhubl S.R., Lincoff A.M., et al. The influence of peripheral arterial disease on outcomes: a pooled analysis of mortality in eight large randomized percutaneous coronary intervention trials. Journal of the American College of Cardiology 2006, 48(8):1567-1572.
59. O'Rourke D.J., Quinton H.B., Piper W., Hernandez F., Morton J., Hettleman B., et al. Survival in patients with peripheral vascular disease after percutaneous coronary intervention and coronary artery bypass graft surgery. The Annals of Thoracic Surgery 2004, 78(2):466-470.
60. Karthik S., Musleh G., Grayson A.D., Keenan D.J.M., Pullan D.M., Dihmis W.C., et al. Coronary surgery in patients with peripheral vascular disease: effect of avoiding cardiopulmonary bypass. The Annals of Thoracic Surgery 2004, 77(4):1245-1249.
61. Stone P.H., Golschlager N. Left main coronary artery disease: review and appraisal. The Journal of Cardiovascular Medicine 1979, 4:165-177.
62. DeMots H., Rosch J., McAnulty J.H., Rahimtoola S.H. Left main coronary artery disease. Cardiovascular Clinics 1977, 8(2):201-211.
63. King S.B., Smith S.C., Hirshfeld J.W., Jacobs A.K., Morrison D.A., Williams D.O., et al. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, writing on behalf of the 2005 Writing Committee. Circulation 2008, 117:261-295.
64. Caracciolo E.A., Davis K.B., Sopko G., Kaiser G.C., Corley S.D., Schaff H., et al. Comparison of surgical and medical group survival in patients with left main equivalent coronary artery disease: long-term CASS experience. Circulation 1995, 91:2335-2344.
65. Ng M.K., Yeung A.C. Left main coronary artery disease: is CABG still the gold standard?. Reviews in Cardiovascular Medicine 2005, 6(4):187-193.
66. Biondi-Zocca G.G., Lotrionte M., Moretti C., Meliga E., Agostoni P., Valgimigli M., et al. A collaborative systematic review and meta-analysis on 1278 patients undergoing percutaneous drug-eluting stenting for unprotected left main coronary artery disease. American Heart Journal 2008, 155(2):274-283.
67. Morice M.C., Serruys P.W., Kappetein A.P., Feldman T.E., Stahle E., Colombo A., et al. Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the syngery between percuatneous coronary intervention with TAXUS and cardiac surgery (SYNTAX) trial. Circulation 2010, 121(24):2645-2653.
68. Beauford R.B., Saunders C.R., Lunceford T.A., Niemeier L.A., Shamji S., Karanam R., et al. Multivessel off-pump revascularization in patients with significant left main coronary artery stenosis: early and midterm outcome analysis. Journal of Cardiac Surgery 2005, 20(2):112-118.
69. Lu J.C.Y., Grayson A.D., Pullan D.M. On-pump versus off-pump surgical revascularization for left main stem stenosis: risk adjusted outcomes. The Annals of Thoracic Surgery 2005, 80(1):136-142.
70. Park S. Stenting versus bypass surgery for the treatment of left main coronary artery disease. Yonsei Medical Journal 2009, 50(6):739-743.
71. Curkendall S.M., DeLuise C., Jones J.K., Lanes S., Stang M.R., Goehring E., et al. Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients. Annals of Epidemiology 2006, 16(1):63-70.
72. Sidney S., Sorel M., Quesenberry C.P., DeLuise C., Lanes S., Eisner M.D. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente medical care program. Chest 2005, 128(4):2068-2075.
73. Mapel D.W., Dedrick D., Davis K. Trends and cardiovascular co-morbidities of COPD patients in the veterans administration medical system, 1991-1999. COPD: Journal of Chronic Obstructive Pulmonary Disease 2005, 2(1):35-41.
74. Falk J.A., Kadiev S., Criner G.J., Scharf S.M., Minai O.A., Diaz P. Cardiac disease in chronic obstructive pulmonary disease. The Proceedings of the American Thoracic Society 2008, 5(4):543-548.
75. Dahl M., Vestbo J., Lange P., Bojesen S.E., Tybjaerg-Hansen A., Nordestgaard B.G. C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease. American Journal of Respiratory Critical Care 2007, 175(3):250-255.
76. Berger J.S., Sanborn T.A., Sherman W., Brown D.L. Effect of chronic obstructive pulmonary disease on survival of patients with coronary heart disease having percutaneous coronary intervention. The American Journal of Cardiology 2004, 94(5):649-651.
77. Selvaraj C.L., Gurm H.S., Gupta R., Ellis S.G., Bhatt D.L. Chronic obstructive pulmonary disease as a predictor of mortality in patients undergoing percutaneous coronary intervention. The American Journal of Cardiology 2005, 96(5):756-759.
78. Cohen A., Katz M., Katz R., Hauptman E., Schachner A. Chronic obstructive pulmonary disease in patients undergoing coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 1995, 109(3):574-581.
79. Cohen A.J., Moore P., Jones C., Miner T.J., Carter W.R., Zurcher R.P., et al. Effect of internal mammary harvest on postoperative pain and pulmonary function. The Annals of Thoracic Surgery 1993, 56:1107-1109.
80. Angouras D.C., Anagnostopoulos C.E., Chamogeorgakis T.P., Rokkas C.K., Swistel D.G., Connery C.P., et al. Post-operative and long-term outcome of patients with chronic obstructive pulmonary disease undergoing coronary artery bypass grafting. The Annals of Thoracic Surgery 2010, 89(4):1112-1118.
81. Medalion B., Katz M.G., Cohen A.J., Hauptman E., Sasson L., Schachner A. Long-term beneficial effect of coronary artery bypass grafting in patients with COPD. Chest 2004, 125(1):56-62.
82. Guler M., Kirali K., Toker M.E., Bozbug N., Omerog S.N., Akinci E., et al. Different CABG methods in patients with chronic obstructive pulmonary disease. The Annals of Thoracic Surgery 2001, 71(1):152-157.
83. Zhu Y.B., Xu J.P., Liu Z.Y., Yang D.N., Li X.D., Li H.Y. Off-pump coronary artery bypass grafting versus on-pump coronary artery bypass grafting: which is better in patients with chronic obstructive pulmonary disease?. Journal of Zhejiang University 2004, 5(8):1005-1008.
84. Lizak M.K., Nash E., Zakliczynski M., Sliwka J., Knapik P., Zembala M. Additional spirometry criteria predict postoperative complications after coronary artery bypass grafting (CABG) independently of concomitant chronic obstructive pulmonary disease: when is off-pump CABG more beneficial?. Polish Archives of Internal Medicine 2009, 119(9):550-557.
85. Nestico P.F., Hakki A.H., Iskandrian A.S. Left ventricular dilatation: prognostic value in severe left ventricular dysfunction secondary to coronary artery disease. Chest 1985, 88:215-220.