On-pump beating-heart CABG was associated with a significantly higher incidence of postoperative arrhythmia and atrial fibrillation compared to off-pump CABG (12.5% vs. 2.53%, p <0.05).
Cohort (n=229)
No
Does on-pump beating-heart CABG improve early postoperative outcomes compared to off-pump CABG in patients undergoing 1-2 graft CABG?
On-pump beating-heart CABG yields similar early postoperative recovery times to off-pump CABG but is associated with a higher risk of postoperative arrhythmia and atrial fibrillation.
Absolute Event Rate: 12.5% vs 2.53%
p-value: p=<0.05
Abstract Background and Aim: Novel surgical approaches are gaining attention in an attempt to overcome possible adverse events following coronary artery bypass graft (CABG) surgery. This single-center study aimed to evaluate and compare the early postoperative outcomes of on-pump beating-heart (OPBH-CABG) versus off-pump CABG surgery in similar risk groups with a total number of 1–2 grafts. Methods: The records of a total of 229 patients who underwent non-emergency, primary, isolated, either OPBH-CABG (n = 32) or off-pump CABG (n = 197) surgery were retrospectively evaluated. Reported outcome measures included baseline data, the number of coronary artery grafts, prophylactic intra-aortic balloon pump, time of extubation from mechanical ventilation, duration of stay in the coronary ICU and hospital, as well as early postoperative complications, in-hospital and early postoperative mortality. Results: The groups were identical with regards to age and BMI. The patients in the off-pump group received a higher number of grafts (1.84 ± 0.36 vs. 1.18 ± 0.39, p <0.0001). The OPBH-CABG group had a higher Euroscore II score (2.514 ± 1.68 vs. 1.706 ± 1.93, p = 0.021). The time to extubation after the surgery, postoperative length of ICU stay, and total length of hospital stay were similar between the groups (p = 0.2228; p = 0.098; p = 0.717, respectively). The incidence of arrythmia and atrial fibrillation was higher in the on-pump group (12.5% vs. 2.53%, p <0.05). One patient in the on-pump, and four patients in the off-pump groups deceased due to postoperative complications. Conclusions: OPBH-CABG surgery is comparable to off-pump CABG in terms of early postoperative outcomes. In patients who underwent OPBH-CABG, the risk of arrythmia and atrial fibrillation should be of concern and solved with optimal strategies.
İlkeli et al. (Mon,) conducted a cohort in Coronary artery disease (n=229). On-pump beating-heart CABG vs. Off-pump CABG was evaluated on Incidence of arrythmia and atrial fibrillation (p=<0.05). On-pump beating-heart CABG was associated with a significantly higher incidence of postoperative arrhythmia and atrial fibrillation compared to off-pump CABG (12.5% vs. 2.53%, p <0.05).