On-Pump Beating-Heart Coronary Artery Bypass: A Propensity Matched Analysis

On-pump beating-heart versus conventional coronary artery bypass grafting for revascularization in patients with severe left ventricular dysfunction: early outcomes

“…12,13,15,19,20 Early surgical outcomes were better in the on-pump beatingheart group in our study, and this result is consistent with those reported in several studies. [18][19][20][21] Postoperative LCOS ratios, perioperative infarction, new IABP insertion (for weaning from the CPB), and duration of inotropic support were significantly lower in the onpump beating-heart group than the conventional group. Postoperatively, intensive care unit and hospital stay as well as hospital costs decreased in the on-pump beatingheart group.…”

“…The mortality of patients with left ventricu lar dysfunction undergoing an on-pump beatingheart technique varies from 2%-8%. 1,3,21 In-hospital mortality was significantly lower in the on-pump beatingheart group than in the conventional group. In our study, mortality was 0.3%, which was low compared with that reported in other studies.…”

“…Mizutani and colleagues 21 have indicated that the onpump beating-heart technique may increase the risk for incomplete revascularization due to shorter duration of surgery and CPB time. But we agree with the conclusions of previous studies that the on-pump beating-heart technique is associated with an adequate number of grafts performed and complete revascularization.…”

“…3,24 Because most patients with left ventricular dysfunction are hemodynamically unstable and have poor perfusion of their visceral organs, the appropriate circulatory support system, such as CPB, should be applied to improve their hemodynamic status and compensate for visceral organ perfusion. 3,6,14,15,20,21 Therefore, the on-pump beating-heart technique offers a lower risk of systemic hypoperfusion during surgery and, as a consequence, superior renal protection.…”

“…This avoids extreme upward retraction of the heart, especially during revascularization of the Cx branch, which might contribute to better myocardial protection. 3,12,13,21,22 Renal failure is a frequent complication in patients who have experienced hemodynamic failure or who have undergone conventional CABG. Most authors have shown that on-pump beating-heart CABG presents a low risk for systemic hypoperfusion during surgery and better renal protection, as demonstrated by a low incidence of postoperative renal complications.…”