An international multi-centre open randomised controlled trial of isolated off-pump CABG (OPCABG) versus on-pump CABG (ONCABG) in high risk patients

Aim of study To test the hypothesis that OPCABG reduces mortality and morbidity in high-risk patients without causing a higher risk of re-intervention Design An open multicenter study Study population 5420 adult, consenting patients having isolated, non emergency CABG surgery Outcome measures Primary Composite endpoint of death or serious morbidity (CRISPSw) Secondary Duration of intensive care unit stay during index hospital admission Duration of hospital stay during index hospital admission Survival free from death, stroke, MI, re-intervention, renal failure and sternal wound infection at 1 year Resource utilisation Quality of life assessment at 1 year Cost-effectiveness

Inclusion criteria Euroscore ≥5 Non-emergency surgery Operation to be carried out via a median sternotomy Written informed patient consent Exclusion criteria Euroscore <5 Emergency operation (immediate revascularisation for haemodynamic instability) Concomitant cardiac procedure with CABG Operation to be carried out via an incision other than a median sternotomy (e.g. anterolateral left thoracotomy) Contraindication to ONCABG or OPCABG (e.g. calcified aorta, intramuscular LAD, calcified coronaries, small target vessels) Contact Chris Rogers Email: chris.rogers@bristol.ac.uk

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