1. Off-Pump Versus On-Pump Coronary Artery Bypass Grafting in Consecutive Patients: Decision-Making Algorithm and Outcomes 
James M. Brown, MD, Robert S. Poston, MD, James S. Gammie, MD, Marcello G. Cardarelli, MD, Kimberly Schwartz, CRNFA, Jo Ann H. Sikora, CRNP, Susan Yi, CRNP, Richard N. Pierson, MD, Bartley P. Griffith, MD 
The Annals of Thoracic Surgery 
Volume 81, Issue 2, Pages (February 2006)
DOI: /j.athoracsur
Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
Decision-making algorithm used to decide between on-pump and off-pump approaches for coronary artery bypass grafting in this consecutive series of 592 patients. Primary consideration was first given to coronary artery anatomy and the complexity of the revascularization needed. Anticipated challenges with distal vessel size quality and location led to an on-pump approach. Given that an off-pump approach could be performed safely, the decision-making method was applied to the patient in terms of the comorbid conditions listed. In general, elderly patients with multiple comorbidities were approached with the off-pump technique. At all steps, surgeon judgment allowed deviation from the decision-making algorithm. For example, an 83-year-old patient with cerebrovascular disease, chronic obstructive pulmonary disease, a large heart, and small obtuse marginal targets would be returned to the off-pump strategy and the small obtuse marginal targets left ungrafted. (AV = atrioventricular; PDA = posterior descending artery; PLA = proximal left ascending artery; RCA = right coronary artery.)
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
(A) Bar graph showing distribution of The Society of Thoracic Surgeons’ (STS) predicted risk in the on-pump group (light bars) and the off-pump coronary artery bypass grafting (OP CAB) group (dark bars). Values on the vertical axis are expressed as the percent of patients within the particular group. The horizontal axis is the predicted risk groupings. The decision-making algorithm resulted in the shifting of the off-pump group to the right or more toward moderate STS predicted risk. (B) Pie chart depicting percent of patients from both the on-pump and off-pump coronary artery bypass grafting (OP CAB) groups that fell into a moderate risk level (between 2.5 and 10 STS predicted risk). More patients (p < 0.01) in the off-pump group were at moderate risk compared with the on-pump group.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions