Prospective Randomised comparison of Off-pump and on-pump MultIvessel coronary artery bypasS Surgery: analysis of early graft patency by multi-slice computed tomography

INTERVENTION: Patients undergo coronary artery bypass grafting with internal mammary artery, radial or saphenous vein in the two groups using the same anaesthetic protocol, the same graft anastomotic techniques and the same peri‐operative (the only exception is heparin dose) and post operative medical treatment. Coronary artery bypass grafting is performed without cardio‐pulmonary bypass (off‐pump group) or with the use of cardio‐pulmonary bypass (on‐pump group). Duration of treatment: two surgical methods are compared in PROMISS so the duration of treatment is that of the surgical procedures (3 ‐ 5 hours). Patients are followed at 1 month (clinical exam) and 6 months (clinical exam, quality of life and stress test). CONDITION: Multivessel coronary artery disease ; Circulatory System ; Cronary artery disease PRIMARY OUTCOME: Graft patency at 4 ‐ 6 weeks evaluated by 16 slice computed tomography. SECONDARY OUTCOME: 1. Post‐operative adverse events ; 2. Neurocognitive testing at baseline and 4 ‐ 6 weeks; 3. Quality of life at baseline and 6 months; 4. Adverse events and stress test at 6 months INCLUSION CRITERIA: 1. Patients between 30 and 90 years 2. Multivessel disease 3. Indication for primary coronary artery bypass graft (CABG) for at least three distal anastomoses according to consensus given by two independent surgeons