Friday, April 30, 2010

MORE EVIDENCE ON " OFF PUMP CABG " FROM BEIJING.

The 12th April 2010 online edition of Circulation, carried a publications by the Chinese ( we are seeing more and more of this now ), from Fu Wai Hospital, led by Prof Shengshou Hu. He compare 6665 CABGs done, 3266 done the " off pump way " and 3399 done the conventional on-pump way. He followed the patients for 4.5 years, and found ( like previous studies ), that the off pump technique tended to have significantly more incomplete re-vascularisation and more CV events following surgery. There were more repeat re-vascularisations, strokes and heart attacks following off-pumps. They did not study the CNS effects as was done by previous investigators like the "ROOBY" study, which showed no difference in CNS outcomes between on-pump and off-pump.
The other findings that is important ( we will see more and more ) is that the outcomes on CABG, both on and off pump, were comparable between the major Chinese centers and the major US or European centers. Looks like the Chinese are beginning to brand themselves with the international community ( in this case, it is the medical field ), as in all other fields. They hold one big advangtage in that their study size tend to be bigger then many other studies.
All in all, it does look like besides the cosmetic advantage, the off-pump CABG technique does not offer much else. Maybe that is why the whole world is still rather unconvinced about it. I suppose, I maybe a little biased on it.
Time will tell.