[Off-pump coronary artery bypass grafting; its impact on renal function]

Area of Science:

• Cardiovascular Surgery
• Nephrology
• Perioperative Medicine

Background:

• Coronary artery bypass grafting (CABG) is a common cardiac procedure.
• Maintaining renal function during CABG is crucial for patient outcomes.
• Off-pump CABG (OPCAB) aims to reduce complications associated with cardiopulmonary bypass.

Purpose of the Study:

• To evaluate the impact of off-pump CABG (OPCAB) on perioperative renal function.
• To compare renal function between OPCAB and conventional on-pump CABG procedures.

Main Methods:

• A retrospective study of 350 patients undergoing isolated CABG between January 1999 and September 2002.
• Patients were divided into two groups: OPCAB (n=214) and on-pump CABG (n=136).
• Perioperative serum creatinine (CRE) levels were analyzed and compared between the groups.

Main Results:

• The incidence of renal impairment (CRE > 1.5 mg/dl) was similar between the OPCAB (8%) and on-pump (4%) groups.
• Postoperative renal impairment rates were comparable: 20% in OPCAB versus 18% in the on-pump group.
• The ratio of postoperative to preoperative CRE was significantly lower in the OPCAB group (1.28) compared to the on-pump group (1.44).

Conclusions:

• Off-pump CABG (OPCAB) demonstrates a trend towards better preservation of renal function compared to on-pump CABG.
• While not reaching statistical significance in all measures, the lower CRE ratio suggests improved renal recovery with OPCAB.
• OPCAB may be a favorable option for patients concerned about perioperative renal function.