Why the study?
Does off-pump CABG improve long-term echocardiographic parameters compared to on-pump CABG in patients with coronary artery disease?
Does off-pump CABG improve long-term echocardiographic parameters compared to on-pump CABG in patients with coronary artery disease?
Off-pump CABG may offer superior long-term preservation of ventricular ejection fraction and lower rates of valve regurgitation compared to on-pump CABG.
Off-pump CABG was associated with better EF preservation and less regurgitation; hypothesis-generating and should not yet change practice.
Background: Coronary artery bypass grafting (CABG) is a revascularization method for coronary artery disease (CAD), which is done with and without cardiopulmonary bypass (CPB). CABG without CPB (off-pump) has been prevalent due to CPB related complications but a number of studies have not demonstrated superiority between these two methods. Objectives: This study designed to evaluate changes in patients’ echocardiography findings during 4 years after CABG with and without CPB. Patients and Methods: 118 patients who underwent CABG were included in this historical cohort study. Demographic data echocardiographs, serum creatinine and hemoglobin before and after surgery extracted from patients’ medical records. In the next visits, history taking, cardiovascular events, physical examination, and echocardiography considered in all patients. Data compared in Off-Pump and On-Pump CABG groups. Results: One hundred eighteen patients with the mean age of 59.47 ± 9.68 years were included (81 male and 37 female). On-pump CABG was done on 84 patients and off-pump on 34 patients. The mean age was significantly more and numbers of atherosclerotic vessels were less in off-pump patients. Left ventricle ejection fraction (EF) was significantly decreased in on-pump group and increased in off-pump group. Right ventricle EF was significantly decreased in both groups, with significant decrease in on-pump patients. Mitral and tricuspid valves regurgitation were significantly more in on-pump patients (P < 0.05). Conclusions: Our study showed superiority of off-pump CABG regarding LVEF, RVEF and valves regurgitations. Future studies with prospective structure, accurate randomization, longer follow up duration, and larger sample size are needed.
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Karimi‐Sari et al. (2015) studied this question.
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