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Updated: Aug 29, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Off-pump versus on-pump myocardial revascularization in low-risk patients with one or two vessel disease:
Luís Roberto Gerola1, Enio Buffolo, Waldir Jasbik
1Division of Cardiovascular Surgery, Department of Surgery, Federal University of São Paulo Brasil, Sao Paolo, Brazil. gerola@uol.com.br
Insights
Comparing on-pump versus off-pump coronary artery bypass grafting in low-risk patients, this study found no significant differences in hospital mortality or morbidity. Both coronary artery bypass grafting (CABG) and off-pump coronary artery bypass (OPCAB) demonstrated similar safety profiles.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Minimally Invasive Cardiac Surgery
Background:
- Myocardial revascularization is a critical procedure for coronary artery disease.
- Comparing on-pump (CABG) and off-pump (OPCAB) techniques is essential for optimizing patient outcomes.
- This study focuses on a specific subset of patients with left descending artery lesions.
Purpose of the Study:
- To compare hospital mortality and morbidity between on-pump and off-pump myocardial revascularization.
- To evaluate the safety and efficacy of CABG versus OPCAB in low-risk patients.
- To analyze outcomes in patients with isolated or associated left descending artery lesions.
Main Methods:
- A multicenter prospective randomized study involving 160 low-risk patients.
- Patients were divided into two groups: 80 undergoing on-pump CABG and 80 undergoing off-pump OPCAB.
- Exclusion criteria included severe left ventricular dysfunction, renal failure, circumflex artery lesions, and significant comorbidities.
Main Results:
- Hospital mortality was low and not statistically different between groups (3.7% on-pump vs. 1.2% off-pump).
- No significant differences were observed in myocardial infarction rates, postoperative bleeding, or transient neurologic dysfunction.
- Intensive care unit stay and operation time were comparable between the on-pump and off-pump groups.
Conclusions:
- On-pump and off-pump techniques show similar hospital mortality and morbidity in selected low-risk patients.
- The choice between CABG and OPCAB may not significantly impact short-term outcomes in this patient population.
- Further research may explore long-term outcomes and cost-effectiveness.
Background:
To evaluate hospital mortality and morbidity after myocardial revascularization in a prospective and multicenter study, comparing on-pump versus off-pump in a special subset of patients with lesions in the left descending artery, alone or associated with the right coronary artery.
Methods:
A multicenter prospective randomized study was performed. One hundred and sixty selected low-risk patients were enrolled; 80 patients were operated on-pump (coronary artery bypass grafting [CABG], group I) and 80 patients were operated off-pump (off-pump coronary artery bypass [OPCAB], group II). One hundred and five were male and ages ranged from 39 to 70 years old; mean 58.81 +/- 9.31 and median 59. Preoperative clinical characteristics were similar in both groups; only previous myocardial infarction was higher in the OPCAB group. Patients with severe left ventricular dysfunction (FE
Results:
Hospital mortality was 2.5%, three patients (3.7%) in group I (on-pump) and one patient (1.2%) in group II (off-pump) (ns). The number of grafts per patients in group I was 1.81 +/- 0.6, and 1.77 +/- 0.68 in group II (p = 0.833). There was no difference in the total operation time 205.10 +/- 54.30 minutes in group I and 189.50 +/- 55.44 in group II (ns). Six patients (7.5%) had myocardial infarction in group I and three (3.7%) in group II (ns). Bleeding in the postoperative period was 680.50 +/- 434.1 mL in the on-pump group and 678.6 +/- 357.0 mL in the off-pump group (ns). Three patients (3.7%) presented transient neurologic dysfunction in group I and six patients (7.5%) in group II (ns). Intensive care stay was 2.4 +/- 1.0 days in the CABG and 2.3 +/- 0.98 days in the OPCAB group (ns).
Conclusions:
We did not find any statistical difference in hospital mortality and morbidity using on-pump or off-pump techniques for low-risk patients.