Key result
Off-pump coronary artery bypass grafting was associated with a significantly lower mortality rate (0.1% vs 1.7%) and reduced postoperative complications compared to on-pump surgery.
Why the study?
To retrospectively evaluate and compare clinical outcomes between patients undergoing off-pump versus on-pump coronary artery bypass grafting.
Does off-pump CABG improve operative and postoperative clinical outcomes compared to on-pump CABG in patients undergoing surgical revascularization?
Cohort (n=1,672)
No
Does off-pump CABG improve operative and postoperative clinical outcomes compared to on-pump CABG in patients undergoing surgical revascularization?
Absolute Event Rate: 0.1% vs 1.7%
p-value: p=0.001
Off-pump CABG is associated with reduced short-term mortality, morbidity, and resource utilization compared to on-pump CABG in selected patients.
May support selective off-pump use in observational settings; leaves open need for randomized confirmation before practice change.
Aim: The aim of this study is to evaluate the clinical results of the patients undergoing off-pump and on-pump coronary artery bypass grafting (CABG) retrospectively in consideration of current literature.Material and Methods: A total of 1672 patients undergoing CABG between October 2014 and August 2016 and having a postoperative sinus rhythm were enrolled in the study. Patients who underwent an additional procedure in addition to CABG and underwent open heart surgery except CABG were excluded from the study. Off-pump CABG was applied to 783 and on-pump CABG to 889 of 1672 patients.Results: In comparison of operative data, duration of operation (p<0.001), number of bypasses to the coronary arteries (p<0.001), number of bypasses of the right coronary artery to the posterior descending artery (p<0.001), and diffuse coronary artery disease (p<0.001) were less in the off-pump CABG group and there was a statistically significant difference. In comparison of postoperative data, postoperative atrial fibrillation development (p<0.001), intubation time (p<0.001), intensive care unit stay (p<0.001), length of hospital stay (p<0.001), reexploration (p=0.006), vasopressor drug usage (p<0.001), positive inotropic drug usage (p<0.001), total drainage (p<0.001), blood and blood product used (p<0.001), and mortality rate (p=0.001) were less in the off-pump CABG group and statistically significant difference was found between groups.Conclusion: In this study, we found that off-pump CABG has many advantages. In a selected group of patients having a coronary artery disease performing CABG in beating heart would avoid the patient from morbid and mortal negative effects of cardiopulmonary bypass.
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Demirdaş et al. (2019) conducted a cohort in Coronary Artery Disease (n=1,672). Off-pump coronary artery bypass grafting (OPCAB) vs. On-pump coronary artery bypass grafting (ONCAB) was evaluated on Mortality (p=0.001). Off-pump coronary artery bypass grafting was associated with a significantly lower mortality rate (0.1% vs 1.7%) and reduced postoperative complications compared to on-pump surgery.
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