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Off-pump coronary artery bypass (OP-CAB) graft surgery is being used with increasing frequency. This study was designed to compare OP-CAB outcomes with conventional surgical revascularization using cardiopulmonary bypass (CPB) in patients with varying risk categories at a high-volume center.Between 1/1/1999 and 1/31/2001, bypass surgery was performed on 1,312 patients, including 348 OP-CAB cases and 964 CPB cases. Compared to CPB cases, OP-CAB patients were more likely to be female and had a lower incidence of three vessel coronary artery disease, prior percutaneous intervention, and prior bypass surgery. Postoperatively, OP-CAB patients had a lower incidence of renal failure and prolonged ventilatory support, as well as a lower composite endpoint of inhospital mortality, perioperative myocardial infarction, cerebrovascular accident, and/or renal failure. In addition, OP-CAB patients required fewer transfusions and had a shorter total length of hospital stay. In general, morbidity and mortality increased in both OP-CAB and CPB groups with increasing Parsonnet score.OP-CAB surgery is a safe and effective alternative to conventional coronary artery bypass graft (CABG) surgery, with a lower incidence of major in-hospital adverse clinical events and a decreased requirement for medical resources. Adverse OP-CAB outcomes correlate well with pre-operative Parsonnet Score.

Tissue specimens obtained from a normal healthy aorta and from a plaque damaged aortal portion were sliced to a thickness of ∼10 μm. They were washed thoroughly with a saline solution to remove traces of hemoglobin and had a neutral grayish-white appearance with no evident chromophores. The samples were supported between CaF2 plates while being measured. Transmittance (7) measurements were performed over the 300–2500-nm spectral region by placing the samples in the entrance port of an integrating sphere reflectometer, an arrangement that captured all the forward scattered beam. The specimens were placed next in an integrating sphere with center-mounted sample and the combined transmittance plus reflectance (T + R) of each was measured over the same wavelength range. The measured absorptance [A = 1− (T + R)] spectra of both normal tissue and tissue containing plaque revealed no discrete absorption features in the 250-700-nm region. In general, absorptance increased toward shorter wavelengths and the greatest difference between the absorptance of normal aortal tissue and plaque occurred in the 250–350-nm region. These results indicate that laser angioplasty may be improved by the use of UV lasers that operate in the 250–350-nm region and can interact more strongly with plaque than with the surrounding arterial wall.