Key result
Beating heart coronary artery bypass surgery showed no significant difference in 30-day mortality compared to conventional on-pump surgery (0% vs 1.8%, P=0.63), but significantly decreased the need for inotropic support and blood transfusion.
Why the study?
Does beating heart coronary bypass surgery improve early postoperative outcomes compared to conventional coronary bypass surgery in patients undergoing isolated CABG?
Cohort (n=1,094)
No
Does beating heart coronary bypass surgery improve early postoperative outcomes compared to conventional coronary bypass surgery in patients undergoing isolated CABG?
Absolute Event Rate: 0% vs 1.8%
p-value: p=0.63
Beating heart coronary artery bypass surgery decreases the need for inotropic support and transfusion compared to conventional CABG, while maintaining similar rates of mortality and major complications.
Beating-heart CABG may reduce perioperative support needs in isolated cases; hypothesis-generating and requires randomized confirmation before practice change.
In this study, we examined the early results for patients who underwent beating heart coronary bypass surgery and compared these results with those of conventional coronary bypass surgery.A total of 1094 patients who underwent isolated coronary artery bypass surgery between January 2009 and December 2011 in our clinic were included in this study. Seventy-three patients in whom cardiopulmonary bypass was not used (group 1) were compared to 1021 patients in whom cardiopulmonary bypass was used (group 2).The mean age was 60.7 ± 9.3 in group 1 and 58.9 ± 9.7 in group 2 (P > 0.05). There was no significant difference between the two groups in terms of gender, or the coexistence of diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), and hypertension (P > 0.05). There was no significant difference between group 1 and group 2 in terms of development of postoperative atrial fibrillation (AF), use of an intra-aortic balloon pump, need for re-operation for bleeding, or duration of hospital stay and intensive care unit stay (P > 0.05). The need for inotropic support and the amount of mediastinal drainage were less in group 1 than in group 2 (P = 0.002, P < 0.001). The incidences of postoperative cerebrovascular accident, development of chronic renal failure, and sternal wound infection did not significantly differ between the groups (P > 0.05). There was no mortality in group 1, whereas it was calculated as 1.8% in group 2 (P = 0.63).Beating heart coronary artery bypass surgery decreases the need for inotropic support and transfusion.
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Çakır et al. (2014) conducted a cohort in Coronary artery disease requiring isolated coronary artery bypass surgery (n=1,094). Beating heart coronary artery bypass surgery (off-pump) vs. Conventional coronary artery bypass surgery with cardiopulmonary bypass (on-pump) was evaluated on 30-day mortality (p=0.63). Beating heart coronary artery bypass surgery showed no significant difference in 30-day mortality compared to conventional on-pump surgery (0% vs 1.8%, P=0.63), but significantly decreased the need for inotropic support and blood transfusion.
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