Related Experiment Video
Updated: Aug 7, 2026
A Recovery Cardiopulmonary Bypass Model Without Transfusion or Inotropic Agents in Rats
Published on: March 23, 2018
Reduced postoperative blood loss and transfusion requirement after beating-heart coronary operations: a prospective
R Ascione1, S Williams, C T Lloyd
1Bristol Heart Institute, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.
Insights
Off-pump coronary artery bypass grafting significantly reduces blood loss and transfusion needs compared to on-pump procedures. This beating heart surgery lowers costs and improves patient outcomes by minimizing complications associated with cardiopulmonary bypass.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for coronary artery disease.
- Conventional CABG utilizes cardiopulmonary bypass (CPB) with cardioplegic arrest.
- Off-pump CABG (OPCAB) on the beating heart offers an alternative without CPB.
Purpose of the Study:
- To compare postoperative blood loss and transfusion requirements between on-pump and off-pump CABG.
- To evaluate the economic impact of transfusion-related costs in both surgical groups.
Main Methods:
- A prospective randomized study involving 200 patients with coronary artery disease.
- Patients were randomized to either on-pump CABG or off-pump CABG.
- Postoperative blood loss, transfusion needs, costs, and hematologic indices were analyzed.
Main Results:
- Off-pump CABG showed significantly lower postoperative blood loss (1.6 times higher in on-pump group).
- Fewer patients required blood transfusions in the off-pump group (77 vs. 48).
- Transfusion-related costs were substantially lower for off-pump CABG ($21.47 vs. $184.8 per patient).
Conclusions:
- Off-pump CABG significantly reduces postoperative blood loss and transfusion requirements.
- Beating heart surgery leads to lower transfusion-related costs compared to conventional CABG with CPB.
- OPCAB is a favorable alternative for revascularization, minimizing complications and expenses.
Objective:
Coronary artery bypass grafting on the beating heart through median sternotomy is a relatively new treatment, which allows multiple revascularization without the use of cardiopulmonary bypass. A prospective randomized study was designed to investigate the effect of coronary bypass with or without cardiopulmonary bypass on postoperative blood loss and transfusion requirement.
Methods:
Two hundred patients with coronary artery disease were prospectively randomized to (1) on-pump treatment with conventional cardiopulmonary bypass and cardioplegic arrest and (2) off-pump treatment on the beating heart. Postoperative blood loss identified as total chest tube drainage, transfusion requirement, and related costs together with hematologic indices and clotting profiles were analyzed.
Results:
There was no difference between the groups with respect to preoperative and intraoperative patient variables. The mean ratio of postoperative blood loss and 95% confidence interval between groups was 1.64 and 1.39 to 1.94, respectively, suggesting on average a postoperative blood loss 1.6 times higher in the on-pump group compared with the off-pump group. Seventy-seven patients in the off-pump group required no blood transfusion compared with only 48 in the on-pump group (P <.01). Furthermore, less than 5% of patients in the on-pump group required fresh frozen plasma and platelet transfusion compared with 30% and 25%, respectively, in the on-pump group (both P <.05). Mean transfusion cost per patient was higher in the on-pump compared with that in the off-pump group ($184.8 +/- $35.2 vs $21.47 +/- $6.9, P <.01).
Conclusions:
Coronary artery bypass grafting on the beating heart is associated with a significant reduction in postoperative blood loss, transfusion requirement, and transfusion-related cost when compared with conventional revascularization with cardiopulmonary bypass and cardioplegic arrest.
More Related Videos
12:40A Modified Murine Heterotopic Heart Transplant Protocol Matching Contemporary Standards of Aseptic Technique, Anesthesia, and Analgesia
Published on: September 28, 2022
05:25Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
