Why the study?
Does off-pump coronary artery bypass (OPCAB) graft surgery improve clinical outcomes and resource utilization compared to conventional on-pump coronary bypass (CCAB) graft surgery?
Does off-pump coronary artery bypass (OPCAB) graft surgery improve clinical outcomes and resource utilization compared to conventional on-pump coronary bypass (CCAB) graft surgery?
This systematic review evaluates the evidence comparing off-pump versus on-pump CABG to provide recommendations on patient selection and potential benefits, particularly in high-risk populations.
Informs selective OPCAB use in high-risk patients; extends evidence synthesis for individualized surgical planning.
The recent development of off-pump coronary artery bypass (OPCAB) graft surgical techniques has led to numerous observational and several randomized trials that have investigated outcomes compared with the current gold standard of conventional on-pump coronary bypass (CCAB) graft surgery. This systematic review assesses the current randomized trials that compare OPCAB and CCAB. Numerous end points were investigated, including mortality, stroke, myocardial infarction, atrial fibrillation, blood transfusions, wound infections, and renal failure. In addition to these important outcomes, resource utilization markers were also examined such as hospital length of stay, intensive care unit length of stay, and duration of intubation/ventilation. Finally, when level I evidence from randomized trials was unavailable, level II evidence was examined. This was done for subgroup analysis, where currently no randomized trials exist, looking at OPCAB in high-risk patients. Recommendations were made as to who should receive OPCAB and the potential benefits in this patient population.
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Bainbridge et al. (2005) studied this question.
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