To the Editor: Shroyer et al. (Aug 17 issue)1 report the 5-year outcomes of the Randomized On/Off Bypass (ROOBY) trial. They conclude that off-pump coronary-artery bypass grafting (CABG) led to lower rates of 5-year survival and event-free survival than on-pump CABG. Although the authors allude to criticism of the trial design that allowed inexperienced surgeons to participate in the off-pump part of the trial, this Achilles’ heel is inadequately explored. The sensitivity analysis, excluding numerous off-pump–to–on-pump conversions (12.4%, vs. a 2.2% national average; the higher rate is a surrogate marker of inexperience) obviated the risk from off-pump CABG. The authors . . .

中文翻译：

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体外循环和体外循环冠状动脉旁路手术后的五年结果

致编辑：Shroyer等。（8月17日发行）1报告了随机开/关绕过（ROOBY）试验的5年结果。他们得出的结论是，非体外循环冠状动脉旁路移植术（CABG）导致的5年生存率和无事件生存率低于体外循环CABG。尽管作者暗示了对试验设计的批评，该试验设计允许经验不足的外科医生参与试验的非常规部分，但这种跟腱的脚跟并未得到充分研究。敏感性分析排除了无数次由泵到泵的转换（12.4％，而全国平均水平为2.2％；较高的比率是缺乏经验的替代标志），避免了由泵外CABG带来的风险。作者。。。