Off-Pump Coronary Artery Bypass Grafting in Patients With Coronary Artery Disease and Concomitant Mitral Valve Regurgitation

Highlights The review presents a retrospective analysis of data of patients who underwent combined coronary artery bypass grafting and mitral valve repair/replacement. The authors comparatively assessed outcomes of off-pump coronary artery bypass grafting (OPCABG) and on-pump CABG (ONCABG) in patients with combined valvular pathology. Abstract Aim . To evaluate the benefits of off-pump coronary artery bypass grafting (OPCABG) in patients with coronary artery disease and concomitant mitral valve (MV) regurgitation. Methods . The study included 50 patients with coronary artery disease and concomitant MV disease who underwent simultaneous CABG and correction of MV regurgitation. Patients were divided into 2 groups: group 1 (n = 26) included patiens with on-pump CABG (ONCABG), group 2 (n = 24) included patiens with OPCABG. Results . In the OPCABG group there was shorter aortic cross-clamping time (85,5 [71,25; 105,25] vs 119 [99,25; 132,25] min, compared with the ONCABG group, p < 0,05), shorter duration of CPB (136,5 [119,25; 158,5] vs 168,5 [142,75; 186,25] min, p < 0,05), and overall duration of the operation (292,5 [252,5; 360] vs 340 [287,5; 385] min, respectively, p = 0,15). Moreover, in this group there was a lower need for transfusion of blood and its components: freshly frozen plasma (2 [2; 3] vs 3 [3; 3], p < 0,05), RBC mass (2 [1; 2] vs 2 [2; 2], respectively, p = 0,4), and lower number of bed-days during hospital stay (20 [13,5; 26,25] vs 23,5 [17,5; 26] days, p < 0,05). Conclusions. Off-pump CABG in patients with combined valvular pathology is a safe and reproducible technique that provides shorter aortic cross-clamping time, on-pump time and operation duration. The need for blood transfusion and the length of hospital stay are reduced as well.