Off-pump versus on-pump coronary artery bypass grafting: oxidative stress and renal function

Area of Science:

• Cardiovascular Surgery
• Nephrology
• Oxidative Stress Research

Background:

• Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (on-pump) is associated with oxidative stress and renal dysfunction.
• The impact of off-pump CABG on these adverse effects remains less understood.

Purpose of the Study:

• To investigate and compare the incidence of oxidative stress and renal dysfunction in patients undergoing on-pump versus off-pump CABG.
• To evaluate specific biomarkers of renal injury and oxidative stress in both surgical groups.

Main Methods:

• A comparative study involving 40 patients undergoing elective CABG, divided into on-pump (n=20) and off-pump (n=20) groups.
• Assessment of renal function via urinary creatinine excretion and measurement of oxidative stress markers including malondialdehyde, hypoxanthine, and xanthine.

Main Results:

• On-pump CABG patients exhibited significant decreases in renal function and significant increases in oxidative stress markers (malondialdehyde, hypoxanthine, xanthine) post-surgery.
• Off-pump CABG patients showed only mild increases in oxidative stress markers with no significant changes in renal function.
• Biomarker levels remained elevated post-surgery in both groups but were significantly higher in the on-pump group at multiple time points.

Conclusions:

• Off-pump CABG is associated with significantly less oxidative stress and no detectable renal dysfunction compared to on-pump CABG.
• These findings suggest off-pump CABG may offer a renal-sparing and less oxidative stress-inducing alternative for patients.