Key result
Off-pump coronary artery bypass grafting decreased early postoperative atrial fibrillation and renal failure compared to conventional CABG in high-risk patients, with no difference in early mortality.
Why the study?
Does off-pump coronary artery bypass grafting (OPCAB) improve early clinical outcomes compared to conventional CABG in high-risk coronary artery disease patients?
Cohort (n=450)
Does off-pump coronary artery bypass grafting (OPCAB) improve early clinical outcomes compared to conventional CABG in high-risk coronary artery disease patients?
In high-risk CAD patients, OPCAB may reduce early postoperative atrial fibrillation and renal failure without compromising other clinical outcomes compared to conventional CABG.
OPCAB was associated with lower early AF and renal failure in high-risk patients; leaves open whether RCTs will confirm benefit over conventional CABG.
Off-pump coronary artery bypass grafting (OPCAB), avoiding the use of cardiopulmonary bypass, has attracted the interest of an increasing number of surgeons and patients, and has assumed an increasing role in surgical practice. Whether OPCAB have better outcome in high-risk patients as compared to Conventional coronary artery bypass grafting (C-GABG) remains to be confirmed. We describe an analysis of early clinical outcomes of high-risk coronary artery disease (CAD) patients, subjected to both techniques. We studied 450 patients with additive EuroSCORE of ≥5 on admission. Patients were divided into 2 groups; Group A was assigned for patients underwent conventional C-CABG, and Group B for patients underwent OPCAB. Data, including gender, age, demographic variables and postoperative complications were extracted from the medical records. Both groups were matched with regard to age, gender, smoking, Diabetes mellitus, dyslipidemia, renal hemodialysis and the mean Euro-Score. We demonstrated a decrease in the incidence of early postoperative atrial fibrillation and renal failure in the Off-pump group. However, we recorded no statistical difference of neurologic complications, acute myocardial infarction or early mortality between the two groups. We recommend OPCAB in high-risk CAD patients, as this technique may carry potential benefits without compromising their clinical outcomes.
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Elmahrouk et al. (2017) conducted a cohort in high-risk coronary artery disease (CAD) (n=450). Off-pump coronary artery bypass grafting (OPCAB) vs. Conventional coronary artery bypass grafting (C-CABG) was evaluated on early clinical outcomes including postoperative atrial fibrillation, renal failure, neurologic complications, acute myocardial infarction, and early mortality. Off-pump coronary artery bypass grafting decreased early postoperative atrial fibrillation and renal failure compared to conventional CABG in high-risk patients, with no difference in early mortality.
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