Off-pump coronary surgery: effect on early mortality and stroke

Area of Science:

• Cardiovascular Surgery
• Surgical Outcomes Research

Background:

• Coronary artery bypass grafting (CABG) is a common procedure.
• Avoiding cardiopulmonary bypass (CPB) in CABG aims to decrease early mortality and morbidity.

Purpose of the Study:

• To compare the early outcomes of off-pump coronary artery bypass (OPCAB) surgery versus conventional on-pump CABG.
• To determine if OPCAB reduces surgical mortality and postoperative stroke.

Main Methods:

• A prospective database was used to compare 389 OPCAB patients with 2412 on-pump CABG patients.
• Patients were analyzed by age groups and risk stratification using the Northern New England risk model.
• Stepwise logistic regression analyzed 32 variables for surgical mortality and stroke endpoints.

Main Results:

• OPCAB patients were older and had higher predicted surgical risk.
• On-pump CABG involved more grafts and higher rates of triple-vessel disease.
• No significant differences were observed in postoperative mortality, stroke, complications, or length of stay between the groups.

Conclusions:

• Off-pump coronary bypass did not demonstrate reduced early mortality or morbidity compared to on-pump procedures.
• Prospective randomized studies are recommended to compare early and late results of both surgical approaches.