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Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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Does off-pump CABG reduce gastrointestinal complications?

Ilhan Sanisoglu1, Mustafa Guden, Zehra Bayramoglu

  • 1Department of Cardiovascular Surgery, Kadir Has University Medical Faculty, Florence Nightingale Hospital, Istanbul, Turkey.

The Annals of Thoracic Surgery
|February 5, 2004
PubMed

Insights

Gastrointestinal complications after coronary artery bypass surgery were similar for on-pump and off-pump techniques. However, prolonged cardiopulmonary bypass, old age, and arteriosclerosis increased risks, suggesting an ischemic injury pattern.

Area of Science:

  • Cardiovascular Surgery
  • Gastrointestinal Complications
  • Surgical Risk Factors

Background:

  • Cardiac surgery involves revascularization techniques, specifically off-pump and on-pump (using cardiopulmonary bypass).
  • Gastrointestinal complications are a known risk following major surgery.
  • Understanding risk factors is crucial for patient outcomes.

Purpose of the Study:

  • To compare gastrointestinal complications and associated risk factors in patients undergoing off-pump versus on-pump coronary artery bypass surgery.
  • To identify specific risk factors contributing to gastrointestinal issues in these patient groups.

Main Methods:

  • Retrospective evaluation of 1146 adult patients undergoing coronary artery surgery over 6 years.
  • Comparison of two groups: 546 patients (off-pump) and 600 patients (on-pump with cardiopulmonary bypass).
  • Analysis of gastrointestinal complications and risk factors using univariate and multivariate logistic regression.

Main Results:

  • Overall mortality was low and similar between groups (1.6% off-pump vs. 2.2% on-pump).
  • Gastrointestinal complication mortality was high and similar (38.5% off-pump vs. 35.7% on-pump).
  • Gastrointestinal bleeding was common in the off-pump group, while intestinal ischemia predominated in the on-pump group.

Conclusions:

  • The incidence of gastrointestinal complications was similar for both on- and off-pump coronary artery bypass surgery.
  • Mortality from gastrointestinal complications remained high, irrespective of surgical technique.
  • Prolonged cardiopulmonary bypass (>98 minutes), advanced age, and arteriosclerosis were identified as significant risk factors for gastrointestinal complications.
Abstract

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