Key result
Off-pump CABG linked to ~67% lower early post-operative morbidity versus conventional on-pump surgery.
Why the study?
Both OPCAB and on-pump CABG have advantages and disadvantages, prompting an analysis of early post-operative outcomes following both procedures in patients with multivessel CAD.
Does off-pump coronary artery bypass grafting improve early post-operative outcomes in patients with multivessel coronary artery disease compared to conventional on-pump CABG?
Cross-Sectional (n=60)
No
Does off-pump coronary artery bypass grafting improve early post-operative outcomes in patients with multivessel coronary artery disease compared to conventional on-pump CABG?
Absolute Event Rate: 13.33% vs 40%
p-value: p=0.001
In patients with multivessel coronary artery disease, off-pump CABG significantly reduced early post-operative morbidity, ICU stay, and myocardial injury compared to conventional on-pump CABG.
Off-pump CABG may lower early morbidity in multivessel disease; leaves open confirmation against on-pump standard in randomized trials.
Background: Both off-pump (OPCAB) and on pump arrest heart coronary artery bypass surgery (CABG) are frequently performed in department of cardiac surgery, NICVD, Dhaka, Bangladesh. Both types of procedures have advantages and disadvantages. This study was conducted to analyze early post-operative outcome following both types of CABG on patients with multivessel coronary artery disease. Methods: Between 1st September 2019 to 28th February 2021, a cross-sectional study was performed with total 60 patients. 30 patients underwent Off Pump coronary artery bypass grafting (OPCAB)(Group A) and 30 patients underwent Conventional Coronary Artery Bypass (CCAB) (Group B) surgery. Preoperative, peroperative and post-operative variables were recorded and analyzed with appropriate statistical tools and p ≤ 0.05 considered statistically significant. Results: Fifty-five male i.e., 91.67% and five female i.e., 8.33% of total patients were participated in this study. Mostly were within forty-five to sixty-four years age group. Preoperative risk factors, family history and drug history had no significant difference (p>0.05). Mean ± SD number of bypass conduits given in each group almost similar and no statistically significant arrhythmia in terms of atrial fibrillation (AF), ventricular tachycardia (VT) and premature ventricular contraction (PVC) were found preoperatively (p>0.05). New onset of early post-operative ECG changes was found in 3 patients of group A and 9 in group B (10 % vs 30%). AF and PVC found in group B significantly (p<0.05) higher than group A. Immediate post-operative troponin I was higher in group B (p = 0.001). Mean ± SD duration of mechanical ventilation, inotropic supports, ICU stay, bleeding and blood transfusion and serum creatinine were significantly higher in group B (p <0.05). Overall immediate and follow up post-operative morbidities were higher in group B than A (p<0.05). Conclusion: Although on pump arrest heart CABG still stands gold standard, in our study we found OPCAB is better than conventional method. Cardiovasc j 2023; 16(1): 1-8
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Reza et al. (2023) conducted a cross-sectional in Multivessel coronary artery disease (n=60). Off-Pump Coronary Artery Bypass Grafting (OPCAB) vs. Conventional Coronary Artery Bypass (CCAB) was evaluated on Post-operative morbidity (p=0.001). Off-pump coronary artery bypass grafting was associated with significantly lower early post-operative morbidity compared to conventional on-pump surgery (13.33% vs 40.0%, p=0.001) in patients with multivessel coronary artery disease.
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