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Related Experiment Videos

Does off-pump coronary surgery reduce morbidity and mortality?

Joseph F Sabik1, A Marc Gillinov, Eugene H Blackstone

  • 1Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. sabikj@ccf.org

The Journal of Thoracic and Cardiovascular Surgery
|September 27, 2002
PubMed
Summary

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Off-pump coronary artery bypass grafting (CABG) showed lower postoperative morbidity compared to on-pump CABG. However, on-pump CABG resulted in more complete revascularization, with similar early mortality rates for both procedures.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Minimally Invasive Cardiac Procedures

Background:

  • Coronary artery bypass grafting (CABG) is a common surgical procedure for coronary artery disease.
  • On-pump CABG utilizes cardiopulmonary bypass, while off-pump CABG is performed without it.
  • Comparing outcomes between these two techniques is crucial for optimizing patient care.

Purpose of the Study:

  • To compare the hospital outcomes of on-pump versus off-pump coronary artery bypass surgery.
  • To identify differences in postoperative morbidity and mortality between the two surgical approaches.

Main Methods:

  • A retrospective analysis of 481 off-pump and 3231 on-pump CABG patients from 1997-2000.
  • Propensity-matched analysis of 406 pairs of on-pump and off-pump patients.

Related Experiment Videos

  • Comparison of baseline characteristics including age, left ventricular function, and comorbidities.

    • Main Results:

    • On-pump CABG involved more grafts (3.5 vs. 2.8) to more coronary territories.
    • Postoperative mortality, stroke, and myocardial infarction were similar between groups.
    • On-pump CABG patients experienced higher rates of encephalopathy, sternal wound infection, red blood cell transfusion, and renal failure requiring dialysis.

    Conclusions:

    • Both on-pump and off-pump CABG yield excellent early clinical results with low mortality.
    • Off-pump CABG is associated with reduced postoperative morbidity.
    • Concerns regarding less complete revascularization in off-pump procedures warrant further investigation into long-term outcomes.