Effects of off-pump versus on-pump coronary artery bypass grafting on early and late right ventricular function

Area of Science:

• Cardiovascular Surgery
• Cardiac Function Assessment
• Surgical Outcomes

Background:

• Conventional on-pump CABG (ONCABG) may impair left ventricular function, while effects on right ventricular (RV) function remain debated.
• Assessing RV function is complex, contributing to conflicting evidence regarding surgical technique impacts.
• Off-pump CABG (OPCABG) is explored for potential benefits in preserving cardiac function.

Purpose of the Study:

• To compare the impact of OPCABG versus ONCABG on right ventricular (RV) function.
• To evaluate RV function changes early post-surgery and at six months.
• To determine if surgical technique influences long-term RV function recovery.

Main Methods:

• A single-center randomized pilot study involving 60 patients with normal left ventricular function undergoing CABG.
• Patients were randomized to either OPCABG or ONCABG.
• Cardiac magnetic resonance imaging (CMR) assessed RV function preoperatively, early postoperatively, and at 6 months.

Main Results:

• No significant preoperative differences in RV function between OPCABG and ONCABG groups.
• Early postoperative RV stroke volume index decreased similarly in both groups (OPCABG: 36+/-7 mL/m², ONCABG: 39+/-11 mL/m²; P=0.41).
• All RV function markers returned to baseline by 6 months, with no significant long-term differences between surgical techniques.

Conclusions:

• Right ventricular (RV) function is transiently impaired following CABG surgery, regardless of technique.
• Both OPCABG and ONCABG result in similar early postoperative RV dysfunction.
• RV function fully recovers by six months post-surgery, indicating comparable long-term outcomes for both methods.