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Early outcome after off-pump versus on-pump coronary bypass surgery: results from a randomized study
D van Dijk1, A P Nierich, E W Jansen
1University Medical Center Utrecht, Department of Anesthesiology, the Julius Center for Patient Oriented Research, Utrecht, The Netherlands.
Circulation
|October 10, 2001
Summary
Off-pump coronary artery bypass grafting (CABG) surgery is safe and offers similar short-term cardiac outcomes compared to on-pump CABG. This approach may reduce the need for blood transfusions and shorten hospital stays.
Area of Science:
- Cardiovascular Surgery
- Minimally Invasive Cardiac Procedures
Background:
- Coronary artery bypass surgery (CABG) traditionally uses cardiopulmonary bypass, associated with significant morbidity.
- Off-pump CABG, facilitated by cardiac stabilizers, offers an alternative but its comparative cardiac outcomes were unclear.
Purpose of the Study:
- To compare the cardiac outcomes of off-pump CABG versus on-pump CABG.
- To evaluate in-hospital results, cardiac outcomes, and quality of life after 1 month.
Main Methods:
- A multicenter trial randomized 281 patients to either off-pump or on-pump CABG.
- Cardiac outcome was defined as survival free of stroke, myocardial infarction, and coronary reintervention.
- Data collected included blood product usage, enzyme release, complications, length of stay, and quality of life.
Main Results:
- Completeness of revascularization was similar between groups.
- Off-pump CABG required fewer blood products (3% vs 13%) and showed less creatine kinase release.
- No significant differences in major complications, 1-month mortality, or quality of life were observed; cardiovascular event-free survival was comparable (93.0% vs 94.2%).
Conclusions:
- Off-pump CABG is a safe alternative for selected patients.
- Short-term cardiac outcomes after off-pump CABG are comparable to on-pump procedures.
- Off-pump CABG may offer benefits such as reduced blood product use and shorter hospital stays.
