Early and long-term outcomes of coronary artery bypass surgery with and without use of heart-lung machine and with special respect to renal function - A retrospective study

Abstract

The aim of our study was to compare early and long-term outcome of patients undergoing either on-pump or off-pump coronary artery bypass grafting with special focus on impairment of renal function. Five hundred ninety-three consecutive patients undergoing coronary artery bypass grafting were retrospectively analyzed. They were assigned either to on-pump (n = 281) or to off-pump (n = 312) group. Early and long-term outcomes were analyzed with special focus on renal function. Basic demographics and preoperative characteristics did not differ between groups (p>0.05) as well as postoperative renal parameters (p>0.05). Postoperative odds ratios (OR) of off-pump group in comparison to on-pump group were higher without reaching significance in terms of incidence of gastrointestinal complications and pneumonia (OR = 2.23 and 1.61, respectively) as well as hazard ratios (HR) on long-term follow-up for mortality and incidence of myocardial infarction (HR = 1.50 and 2.29, respectively). Kaplan-Meier estimation analysis also revealed similar results for both groups in terms of mid- and long-term survival (Breslow p = 0.062 and Log-Rank p = 0.064, respectively) and for incidence of myocardial infarction (Breslow p = 0.102 and Log-Rank p = 0.103, respectively). Our study suggests that use or not use of coronary artery bypass did not influence postoperative renal function. Odds of early outcomes were similar in both groups as well as incidence of myocardial infarction and mortality in long-term follow-up.

Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization

“…The off-pump method of surgical procedures described in our analysis allowed us to minimalize the influence of post-operative inflammatory response on our results. Several studies confirmed that the off-pump surgical revascularization technique omits the risk for inflammatory activation secondary to CBP administration [ 40 – 43 ]. In the Mirhafez et al [ 41 ] study serum cytokines levels in off-pump coronary surgery were lower compared with on-pump method.…”

Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus in Two Patients With Previous Coronary Artery Bypass Graft: Strategy for Surgical Removal

“…Dealing with RCC and TT either below or above the diaphragm forced us to think how to resect them without using CBP ( 9 , 10 ). The goal was to avoid sternotomy and complications related to CPB ( 11 ). Redo sternotomy due to prior CABG is technically challenging, because of increased risk of adhesions and injury to critical structures ( 5 ).…”

Comparative effects of off-pump and multiple cardiopulmonary bypass strategies in coronary artery bypass grafting surgery: protocol for a systematic review and network meta-analysis

“…[18][19][20][21][22][23] Over the last two decades, many studies have been dedicated to proving the safety of these strategies by comparing them with conventional ONCAB. [23][24][25][26][27][28][29] Few studies directly compared the effectiveness of CABG surgery under off-pump, ON-BH and MiECC to power for convincing clinical benefits in short-term and longterm outcomes of these three interventions. Network meta-analysis (NMA), as an extension of pairwise metaanalysis, allows the evaluation of multiple treatments in a single analysis.…”

“…Over the last two decades, many studies have been dedicated to proving the safety of these strategies by comparing them with conventional ONCAB 23–29. Few studies directly compared the effectiveness of CABG surgery under off-pump, ON-BH and MiECC to power for convincing clinical benefits in short-term and long-term outcomes of these three interventions.…”