Early outcome of off-pump versus on-pump coronary revascularization

Saeed Davoodi, Abbasali Karimi, Seyed Hossein Ahmadi, Mehrab Marzban, Namvar Movahhedi, Kyomars Abbasi, Abbas Salehi Omran, Mahmood Shirzad, Mehrdad Sheikhvatan, Seyed Hesameddin Abbasi, Payvand Bina, Saeed Davoodi, Abbasali Karimi, Seyed Hossein Ahmadi, Mehrab Marzban, Namvar Movahhedi, Kyomars Abbasi, Abbas Salehi Omran, Mahmood Shirzad, Mehrdad Sheikhvatan, Seyed Hesameddin Abbasi, Payvand Bina

Abstract

Introduction: The use of coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB) or without CPB technique (off-pump) can be associated with different mortality and morbidity and their outcomes remain uncertain. The goal of this study was to evaluate the early outcome of on-pump versus off-pump CABG.

Methods: We conducted a retrospective database review of 13866 patients (13560 patients undergoing on-pump CABG and 306 patients undergoing off-pump CABG) at Tehran Heart Center between January 2002 and January 2007. We compared preoperative, operative, and postoperative characteristics between them.

Results: In-hospital mortality in the on-pump group was 0.8% compared to 0.7% in the off-pump group (P=0.999) and in-hospital morbidity was 11.7% and 6.5%, respectively (OR: 1.533, 95%CI: 0.902-2.605, P=0.114). Postoperative atrial fibrillation was more prevalent in on-pump versus off-pump surgery (6.0% vs 3.0%, P=0.028), however there were no statistical significant differences in other postoperative complications with regard to cardiac arrest (P=0.733), prolonged ventilation (P=0.363), brain stroke (P=0.999), renal failure (P=0.525), and postoperative bleeding (P=0.999). The mean length of stay in hospital (P=0.156) and in ICU (P=0.498) was also similar between the two groups.

Conclusion: The results from an Iranian population-based study showed similar early mortality and morbidity of off-pump CABG in comparison to on-pump surgery.

Keywords: Cardiopulmonary bypass; Coronary artery bypass grafting; Off-pump; Outcome.

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