This trial is active, not recruiting.

Conditions heart disease, cardiovascular disease
Treatment coronary artery bypass grafting
Phase phase 3
Sponsor Rigshospitalet, Denmark
Collaborator Danish Heart Foundation
Start date April 2002
End date March 2006
Trial size 341 participants
Trial identifier NCT00120991, 2001-11-DP-83-RKF-22


There is evidence linking cardiopulmonary bypass to negative side effects when used for coronary artery bypass grafting. Coronary artery bypass grafting can be performed without the use of cardiopulmonary bypass. The purpose of this study is to determine the positive and negative effects of coronary artery bypass grafting with or without the use of cardiopulmonary bypass. The patients will be followed at least one year after surgery.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification safety/efficacy study
Intervention model parallel assignment
Masking single blind (outcomes assessor)
Primary purpose treatment

Primary Outcomes

All cause mortality
time frame: Short and long term
Acute myocardial infarction
time frame:
Cardiac arrest with successful resuscitation
time frame:
Low cardiac output syndrome/cardiogenic shock
time frame:
time frame:
Need for renewed cardiac revascularization procedure
time frame:

Secondary Outcomes

Hyper dynamic shock
time frame:
Atrial fibrillation during index admission
time frame:
Need for pacing > 24 hours
time frame:
Renal complications, i.e., increased serum creatinine
time frame:
Reoperation for bleeding during index admission
time frame:
time frame:
Respiratory insufficiency requiring intubation > 24 hours postoperatively
time frame:
Serious adverse events
time frame:
Duration of stay in intensive care unit
time frame:
Duration of stay in the hospital
time frame:
Quality of life after 3 and 12 month
time frame:
Graft patency at one year postoperatively defined by coronary angiography.
time frame:

Eligibility Criteria

Male or female participants at least 55 years old.

Inclusion Criteria: - Known ischemic three vessel heart disease affecting one of the marginal coronary arteries - Age > 54 years - Scheduled for elective or subacute CABG - EuroSCORE > 4 and < 17 - The patient has signed written informed consent before randomization and surgery. Exclusion Criteria: - Previous heart surgery - Ejection fraction < 30 % - Unstable preoperative condition, i.e., continuous infusion of inotropics on the day of the operation - Patient unable to give informed consent.

Additional Information

Official title Off-Pump Coronary Artery Bypass Grafting Versus Conventional Coronary Artery Bypass Grafting on Postoperative Mortality and Morbidity, A Randomized Clinical Trial
Principal investigator Christian H. Møller, MD
Description Objectives: To evaluate the beneficial and harmful effects of off-pump coronary artery bypass grafting (OPCAB) versus conventional coronary artery bypass grafting (CCABG) using a heart- and lung machine in patients with three-vessel coronary artery disease. Trial population: Consecutive patients > 54 years of age with three-vessel coronary artery disease with EuroSCORE of 5-16 undergoing elective or sub-acute coronary artery bypass grafting, giving written informed consent, and where randomisation can be accomplished preoperatively. The study will include 330 patients. Trial design: The Best Bypass Surgery Trial (BBS Trial) is a randomised trial. Patients will be randomised to one of two groups. The randomisation will be 1:1, in blocks, stratified by gender, age (55 to 65 years; > 65 years), diabetes mellitus, and EuroSCORE (5-7; 8-10; 11-13; 14-16). The patients will be randomised to OPCAB surgery or CCABG surgery. The interventions: In the OPCAB group, the revascularization procedure will be performed on the beating heart with a stabilizer to demobilize the target coronary arteries. When access is needed for posterior coronary arteries a suction device will lift the heart. In the CCABG group, the revascularization procedure will be performed with the use of a heart- and lung machine in normothermia, aortic cross clamp, and with cold cardioplegic arrest. In both groups, the left internal mammary artery and saphenous vein grafts are standard graft material. Outcome measures: The aim of the study is to examine the value of OPCAB revascularization compared to CCABG revascularization on the following outcome measures: - Primary: The composite outcome measure of mortality (of all causes), acute myocardial infarction, cardiac arrest with successful resuscitation, low cardiac output syndrome, or major neurological deficit. - Secondary: Hyper dynamic shock; atrial fibrillation, respiratory insufficiency requiring intubation >24 hours , need for pacing > 1 day due to 2º AV-blockage or nodal rhythm; renal complications, i.e., serum creatinine > 200 μmol/l, or need for acute dialysis; re-operation for bleeding, pneumonia; serious adverse events; duration of stay in intensive care unit; duration of stay in the hospital; quality of life after 3 and 12 month; graft patency at one year postoperatively defined by coronary angiography. In addition, cognitive function will be assessed after three and 12 months in the first 120 patients randomized.
Trial information was received from ClinicalTrials.gov and was last updated in February 2008.
Information provided to ClinicalTrials.gov by Rigshospitalet, Denmark.