Off-pump versus on-pump coronary artery bypass grafting: comparative effectiveness
Key result
Off-pump CABG is associated with similar mortality, myocardial infarction, and stroke compared with on-pump CABG, but results in fewer distal anastomoses and increased repeat revascularization rates.
Why the study?
Does off-pump CABG improve clinical outcomes compared to on-pump CABG in patients undergoing coronary artery bypass grafting?
Population
Patients undergoing coronary artery bypass grafting (CABG)
Comparison
Off-pump coronary artery bypass grafting (CABG) vs On-pump coronary artery bypass grafting with…
Design
Review
Authors
Discussion
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Member takes
Implication
No superiority for off-pump CABG; reinforces on-pump as standard for most patients.
Structured PICO
Does off-pump CABG improve clinical outcomes compared to on-pump CABG in patients undergoing coronary artery bypass grafting?
P
Population
Patients undergoing coronary artery bypass grafting (CABG)
I
Intervention
Off-pump coronary artery bypass grafting (CABG)
C
Comparator
On-pump coronary artery bypass grafting (CABG) with cardiopulmonary bypass
O
Outcome
Hard outcomes including mortality, myocardial infarction, stroke, repeat revascularization, saphenous vein graft patency, and number of distal anastomoseshard clinical
Off-pump CABG yields similar mortality and organ protection to on-pump CABG but is associated with fewer distal anastomoses, worse vein graft patency, and higher repeat revascularization rates.
Limitations
- The impact of learning curve on outcomes remains a valid issue
- Impact of learning curve on outcomes remains a valid issue
Cite This Study
Shahzad G. Raja (2015) conducted a review in Coronary artery disease requiring coronary artery bypass grafting. Off-pump CABG vs. On-pump CABG was evaluated on Mortality, myocardial infarction, and stroke. Off-pump CABG is associated with similar mortality, myocardial infarction, and stroke compared with on-pump CABG, but results in fewer distal anastomoses and increased repeat revascularization rates.