Off-pump versus on-pump coronary-artery bypass grafting in fragile patients (fragile)

Advances in modern Medicine have led to people living longer and healthier lives. Fragile is an emerging concept in Medicine yet to be explored as a risk factor in cardiac surgery. The optimize surgical myocardial revascularization to all clinical scenarios, compare Off-Pump Coronary Artery Bypass graft (OPCAB) versus on-pump Coronary Artery Bypass Graft (CABG), not yet unveiled. In this context, the randomized, controlled clinical trials so far have primarily focused only on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS) but not in fragile patients. Medicine advancing a new approach that makes health care more predictive, preventive, participatory, and mainly personalized. Therefore, we believe OPCAB could be an important technique in patients with limited functional capacity to respond to surgical stress. In this study, the authors introduce a national, multicentre, randomized, controlled trial "fragile" to be developed in the main cardiac surgery centers of Brazil, to clarify the potential benefit of OPCAB in fragile patients. (AU)