On- or Off-pump Coronary Artery Bypass Surgery. Is the Debate Settling Down?

Gomes, Walter J.; Angelini, Gianni D

doi:10.21470/1678-9741-2019-0281

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…The complications related to aortic crossclamping or cardioplegic arrest during conventional CABG surgery have been well documented in patients with poor preoperative condition. 9,11 In our study, we aimed to compare the operative and early postoperative data of two patient groups that underwent CABG with OBPH and off-pump surgery modalities. We found that there were no significant differences between the OBPH and off-pump surgery groups with regards to postoperative extubation duration, length of ICU and hospital stay, and complications.…”

Section: Discussionmentioning

confidence: 99%

On-Pump Beating Heart versus Off-Pump Coronary Artery Bypass Graft Surgery: Short-Term Follow-up Outcomes of a Single Center

İlkeli

Düzgün

2021

Journal of Cardiovascular Emergencies

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Background and Aim: Novel surgical approaches are gaining attention in an attempt to overcome possible adverse events following coronary artery bypass graft (CABG) surgery. This single-center study aimed to evaluate and compare the early postoperative outcomes of on-pump beating-heart (OPBH-CABG) versus off-pump CABG surgery in similar risk groups with a total number of 1–2 grafts. Methods: The records of a total of 229 patients who underwent non-emergency, primary, isolated, either OPBH-CABG (n = 32) or off-pump CABG (n = 197) surgery were retrospectively evaluated. Reported outcome measures included baseline data, the number of coronary artery grafts, prophylactic intra-aortic balloon pump, time of extubation from mechanical ventilation, duration of stay in the coronary ICU and hospital, as well as early postoperative complications, in-hospital and early postoperative mortality. Results: The groups were identical with regards to age and BMI. The patients in the off-pump group received a higher number of grafts (1.84 ± 0.36 vs. 1.18 ± 0.39, p <0.0001). The OPBH-CABG group had a higher Euroscore II score (2.514 ± 1.68 vs. 1.706 ± 1.93, p = 0.021). The time to extubation after the surgery, postoperative length of ICU stay, and total length of hospital stay were similar between the groups (p = 0.2228; p = 0.098; p = 0.717, respectively). The incidence of arrythmia and atrial fibrillation was higher in the on-pump group (12.5% vs. 2.53%, p <0.05). One patient in the on-pump, and four patients in the off-pump groups deceased due to postoperative complications. Conclusions: OPBH-CABG surgery is comparable to off-pump CABG in terms of early postoperative outcomes. In patients who underwent OPBH-CABG, the risk of arrythmia and atrial fibrillation should be of concern and solved with optimal strategies.

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Section: Discussionmentioning

confidence: 99%

On-Pump Beating Heart versus Off-Pump Coronary Artery Bypass Graft Surgery: Short-Term Follow-up Outcomes of a Single Center

İlkeli

Düzgün

2021

Journal of Cardiovascular Emergencies

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“…For more than 30 years, revascularisation has been the gold standard therapy for symptomatic severe left main coronary artery disease (LM-CAD). 2 Coronary artery bypass grafting (CABG) is still the most common type of cardiac surgery performed. On-pump and off-pump are the two most common CABG types.…”

Section: Introductionmentioning

confidence: 99%

Off-pump versus on-pump coronary artery bypass grafting in patients with left main disease: a randomized controlled trial

et al. 2023

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Objective: To compare the outcome of off-pump and on-pump coronary artery bypass graft surgery in patients with left main coronary artery disease.Method: The randomised, controlled, prospective, multicentric study was conducted in 2020 during the period from January 2020 to December 2020 at Kafrelsheikh University Hospital, International Cardiac Centre and Alexandria New Medical Centre, Egypt, and comprised patients with left main coronary artery disease who underwent coronary artery bypass graft surgery. The patients were randomised to on-pump surgery group I (Control Group) and off-pump surgery group II(Interventional Group). All patients were assessed pre-operatively for the presence of comorbid conditions and post-operatively for myocardial infarction, acute kidney injury, pneumonia, sternal dehiscence and 3-month mortality. Data was analysed using SPSS 20.Results: Of the 60 patients, 44(73.3%) were men and 16(26.6%) were women. The overall mean age was 66.4±9.2 years. There were 30(50%) patients in each of the two groups. There were 2(6.7%) cases of myocardial infarction in group I and 1(3.3%) in group II. There was 1(3.3%) case of acute kidney injury in group I and none in group II. There were 3(10%) cases of pneumonia in group 1 compared to 1(3.3%) in group II. There was 1(3.3%) case of sternal dehiscence in group I and none in group II. Mortality at 3 months was 2(6.7%) in group I and 1(3.3%) in group II. There was no significant difference with respect to outcome between the groups (p>0.05).Conclusion: Off-pump coronary artery bypass graft surgery was found to be efficient and non-inferior to on-pump procedure in patients with left main coronary artery disease.Keywords: Coronary artery, Bypass, Myocardial infarction, Kidney, Diabetes, Myocardium, Pneumonia

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“…There is an ongoing debate on which of the currently methods used “on-pump” or “off-pump” CABG have the most favorable outcomes. 8 The criteria that determine which method will be followed each time may vary among different medical centers. However, studies have reported different advantages and disadvantages when comparing the 2 procedures.…”

mentioning

confidence: 99%

Preoperative Antiplatelet Therapy and Bleeding Risk in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A Fine Balance

et al. 2020

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On- or Off-pump Coronary Artery Bypass Surgery. Is the Debate Settling Down?

Cited by 4 publications

References 30 publications

On-Pump Beating Heart versus Off-Pump Coronary Artery Bypass Graft Surgery: Short-Term Follow-up Outcomes of a Single Center

On-Pump Beating Heart versus Off-Pump Coronary Artery Bypass Graft Surgery: Short-Term Follow-up Outcomes of a Single Center

Off-pump versus on-pump coronary artery bypass grafting in patients with left main disease: a randomized controlled trial

Preoperative Antiplatelet Therapy and Bleeding Risk in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A Fine Balance

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