On Versus Off Pump Myocardial Revascularization Study

NCT ID: NCT01290952

Last Updated: 2016-11-21

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

411 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-09-30

Study Completion Date

2011-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Compare completeness and modality of revascularization, operative and postoperative results and 1 year clinical outcomes in unselected high risk patients referred for primary coronary artery bypass surgery. Patients will be randomized to undergo off-pump coronary artery bypass graft (OPCAB) or coronary artery bypass graft with cardiopulmonary bypass (CPB/CAB).

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The initial application of off-pump coronary artery bypass in the early nineties was mainly directed to highly selected and relatively low risk surgical patients. Since then there has been a growing body of evidence suggesting many potential advantages of the OPCAB technique over the conventional cardiopulmonary bypass (CPB) technique in different groups of high-risk patients.

On-off study is a multicentre, prospective, randomized, parallel, trial.Patients indicated for elective or urgent isolated coronary artery bypass graft with additive European System for Cardiac Operative Risk Evaluation ≥ 6 were enrolled. Patients in cardiogenic shock were excluded. Patients were randomly assigned either to coronary artery bypass surgery with cardiopulmonary bypass (ON arm) or to off-pump coronary artery bypass graft (OFF arm). The composite primary end point included operative mortality, myocardial infarction, stroke, renal failure, re-operation for bleeding and adult respiratory distress syndrome, within 30 days after surgery. The total planned sample size was 693 patients; the actual number of enrolled patients was 411,according to the results of the interim analysis scheduled at 400 enrollments (alfa-spending=0.029, Pocock method).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Coronary Artery Disease

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

off-pump bypass coronary artery surgery

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Off-pump bypass surgery

Off-pump coronary artery bypass graft (OPCAB) using mandatory a stabilization device and advisable, but not mandatory, a heart positioner

Group Type EXPERIMENTAL

Off-pump bypass surgery

Intervention Type PROCEDURE

is a method of performing a coronary bypass operation for the purpose of treating advanced coronary heart disease while the heart is still beating normally.

On-pump bypass surgery

coronary artery bypass graft with cardiopulmonary bypass (CPB/CAB)

Group Type ACTIVE_COMPARATOR

On-pump bypass surgery

Intervention Type PROCEDURE

is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Off-pump bypass surgery

is a method of performing a coronary bypass operation for the purpose of treating advanced coronary heart disease while the heart is still beating normally.

Intervention Type PROCEDURE

On-pump bypass surgery

is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the body.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Pts candidate to a myocardial revascularization for any patter of coronary artery disease, ventricular dysfunction or any other co-morbidity
* EUROSCORE ≥ 6
* Pts who signed the Informed Consent
* Age ≥ 18 years

Exclusion Criteria

* Patients in cardiogenic shock requiring emergency surgery or preoperative intra-aortic balloon pump
* Patients requiring additional surgical procedures
* Porcelain Aorta
* Lack of informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Medtronic Italia

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Massimo Lemma, Dr.

Role: PRINCIPAL_INVESTIGATOR

Ospedale Sacco-Milano

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Policlinico

Bari, , Italy

Site Status

S. Anna e S. Sebastiano

Caserta, , Italy

Site Status

Ospedale Luigi Sacco

Milan, , Italy

Site Status

European Hospital

Roma, , Italy

Site Status

Ospedale S. Camillo

Roma, , Italy

Site Status

Ospedale S. Giovanni di Dio e Ruggi d'Aragona

Salerno, , Italy

Site Status

Ospedale Molinette

Torino, , Italy

Site Status

University Hospital

Zurich, , Switzerland

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Italy Switzerland

References

Explore related publications, articles, or registry entries linked to this study.

Benetti FJ, Naselli G, Wood M, Geffner L. Direct myocardial revascularization without extracorporeal circulation. Experience in 700 patients. Chest. 1991 Aug;100(2):312-6. doi: 10.1378/chest.100.2.312.

Reference Type BACKGROUND
PMID: 1677884 (View on PubMed)

Yokoyama T, Baumgartner FJ, Gheissari A, Capouya ER, Panagiotides GP, Declusin RJ. Off-pump versus on-pump coronary bypass in high-risk subgroups. Ann Thorac Surg. 2000 Nov;70(5):1546-50. doi: 10.1016/s0003-4975(00)01922-6.

Reference Type BACKGROUND
PMID: 11093485 (View on PubMed)

Arom KV, Flavin TF, Emery RW, Kshettry VR, Janey PA, Petersen RJ. Safety and efficacy of off-pump coronary artery bypass grafting. Ann Thorac Surg. 2000 Mar;69(3):704-10. doi: 10.1016/s0003-4975(99)01510-6.

Reference Type BACKGROUND
PMID: 10750747 (View on PubMed)

D'Ancona G, Karamanoukian HL, Soltoski P, Salerno TA, Bergsland J. Changing referral pattern in off-pump coronary artery bypass surgery: a strategy for improving surgical results. Heart Surg Forum. 1999;2(3):246-9.

Reference Type BACKGROUND
PMID: 11276485 (View on PubMed)

Ascione R, Lloyd CT, Gomes WJ, Caputo M, Bryan AJ, Angelini GD. Beating versus arrested heart revascularization: evaluation of myocardial function in a prospective randomized study. Eur J Cardiothorac Surg. 1999 May;15(5):685-90. doi: 10.1016/s1010-7940(99)00072-x.

Reference Type BACKGROUND
PMID: 10386418 (View on PubMed)

Vallely MP, Bannon PG, Kritharides L. The systemic inflammatory response syndrome and off-pump cardiac surgery. Heart Surg Forum. 2001;4 Suppl 1:S7-S13. No abstract available.

Reference Type BACKGROUND
PMID: 11178301 (View on PubMed)

Cartier R, Brann S, Dagenais F, Martineau R, Couturier A. Systematic off-pump coronary artery revascularization in multivessel disease: experience of three hundred cases. J Thorac Cardiovasc Surg. 2000 Feb;119(2):221-9. doi: 10.1016/S0022-5223(00)70176-0.

Reference Type BACKGROUND
PMID: 10649196 (View on PubMed)

Krejca M, Skiba J, Szmagala P, Gburek T, Bochenek A. Cardiac troponin T release during coronary surgery using intermittent cross-clamp with fibrillation, on-pump and off-pump beating heart. Eur J Cardiothorac Surg. 1999 Sep;16(3):337-41. doi: 10.1016/s1010-7940(99)00234-1.

Reference Type BACKGROUND
PMID: 10554854 (View on PubMed)

Ascione R, Nason G, Al-Ruzzeh S, Ko C, Ciulli F, Angelini GD. Coronary revascularization with or without cardiopulmonary bypass in patients with preoperative nondialysis-dependent renal insufficiency. Ann Thorac Surg. 2001 Dec;72(6):2020-5. doi: 10.1016/s0003-4975(01)03250-7.

Reference Type BACKGROUND
PMID: 11789787 (View on PubMed)

Kilo J, Czerny M, Gorlitzer M, Zimpfer D, Baumer H, Wolner E, Grimm M. Cardiopulmonary bypass affects cognitive brain function after coronary artery bypass grafting. Ann Thorac Surg. 2001 Dec;72(6):1926-32. doi: 10.1016/s0003-4975(01)03199-x.

Reference Type BACKGROUND
PMID: 11789773 (View on PubMed)

Calafiore AM, Di Mauro M, Contini M, Di Giammarco G, Pano M, Vitolla G, Bivona A, Carella R, D'Alessandro S. Myocardial revascularization with and without cardiopulmonary bypass in multivessel disease: impact of the strategy on early outcome. Ann Thorac Surg. 2001 Aug;72(2):456-62; discussion 462-3. doi: 10.1016/s0003-4975(01)02810-7.

Reference Type BACKGROUND
PMID: 11515882 (View on PubMed)

Al-Ruzzeh S, Nakamura K, Athanasiou T, Modine T, George S, Yacoub M, Ilsley C, Amrani M. Does off-pump coronary artery bypass (OPCAB) surgery improve the outcome in high-risk patients?: a comparative study of 1398 high-risk patients. Eur J Cardiothorac Surg. 2003 Jan;23(1):50-5. doi: 10.1016/s1010-7940(02)00654-1.

Reference Type BACKGROUND
PMID: 12493504 (View on PubMed)

Vlassov GP, Deyneka CS, Travine NO, Timerbaev VH, Ermolov AS. Acute myocardial infarction: OPCAB is an alternative approach for treatment. Heart Surg Forum. 2001;4(2):147-50; discussion 150-1.

Reference Type BACKGROUND
PMID: 11544627 (View on PubMed)

Yeatman M, Caputo M, Ascione R, Ciulli F, Angelini GD. Off-pump coronary artery bypass surgery for critical left main stem disease: safety, efficacy and outcome. Eur J Cardiothorac Surg. 2001 Mar;19(3):239-44. doi: 10.1016/s1010-7940(01)00572-3.

Reference Type BACKGROUND
PMID: 11251259 (View on PubMed)

Geissler HJ, Holzl P, Marohl S, Kuhn-Regnier F, Mehlhorn U, Sudkamp M, de Vivie ER. Risk stratification in heart surgery: comparison of six score systems. Eur J Cardiothorac Surg. 2000 Apr;17(4):400-6. doi: 10.1016/s1010-7940(00)00385-7.

Reference Type BACKGROUND
PMID: 10773562 (View on PubMed)

Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999 Jul;16(1):9-13. doi: 10.1016/s1010-7940(99)00134-7.

Reference Type BACKGROUND
PMID: 10456395 (View on PubMed)

Shroyer AL, Grover FL, Hattler B, Collins JF, McDonald GO, Kozora E, Lucke JC, Baltz JH, Novitzky D; Veterans Affairs Randomized On/Off Bypass (ROOBY) Study Group. On-pump versus off-pump coronary-artery bypass surgery. N Engl J Med. 2009 Nov 5;361(19):1827-37. doi: 10.1056/NEJMoa0902905.

Reference Type BACKGROUND
PMID: 19890125 (View on PubMed)

Khan NE, De Souza A, Mister R, Flather M, Clague J, Davies S, Collins P, Wang D, Sigwart U, Pepper J. A randomized comparison of off-pump and on-pump multivessel coronary-artery bypass surgery. N Engl J Med. 2004 Jan 1;350(1):21-8. doi: 10.1056/NEJMoa031282.

Reference Type BACKGROUND
PMID: 14702424 (View on PubMed)

Puskas JD, Thourani VH, Kilgo P, Cooper W, Vassiliades T, Vega JD, Morris C, Chen E, Schmotzer BJ, Guyton RA, Lattouf OM. Off-pump coronary artery bypass disproportionately benefits high-risk patients. Ann Thorac Surg. 2009 Oct;88(4):1142-7. doi: 10.1016/j.athoracsur.2009.04.135.

Reference Type BACKGROUND
PMID: 19766798 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

030211

Identifier Type: -

Identifier Source: org_study_id