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Updated: Jul 2, 2026
Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
Published on: September 15, 2023
Off-pump versus on-pump--intermittent aortic cross clamping--myocardial revascularisation: single center expirience
Igor Medved1, Darko Anić, Boris Zrnić
1Department of Cardiac Surgery, University Hospital Rijeka, Rijeka, Croatia. igor.medved@ri.t-com.hr
Insights
This study compared on-pump coronary artery bypass graft (CABG) and off-pump coronary artery bypass graft (OPCAB) surgery for multivessel coronary artery disease. Neither surgical method demonstrated superiority in hospital mortality or morbidity outcomes.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Myocardial Revascularization
Background:
- Multivessel coronary artery disease necessitates revascularization strategies.
- Coronary artery bypass grafting (CABG) is a common treatment.
- On-pump CABG (OPCAB) and off-pump CABG (OPCAB) are two surgical approaches with differing procedural characteristics.
Purpose of the Study:
- To compare hospital mortality and morbidity between on-pump CABG and OPCAB in patients with multivessel coronary artery disease.
- To evaluate postoperative outcomes, including enzyme release, bleeding, and intensive care unit (ICU) stay.
- To determine if one surgical technique offers superior results over the other.
Main Methods:
- A randomized, prospective study involving sixty patients with multivessel coronary artery disease.
- Patients were randomized to either on-pump CABG or OPCAB surgery.
- Data collected included hospital mortality, morbidity, Creatine Kinase-MB (CK-MB) levels, bleeding, and ICU stay.
Main Results:
- No significant difference was observed in overall hospital mortality or major morbidity between the on-pump and OPCAB groups.
- Statistically significant differences were noted in postoperative Creatine Kinase-MB (CK-MB) release, amount of bleeding, and ICU length of stay (p<0.05).
- These specific markers indicated variations in myocardial injury and recovery, but not in overall clinical outcomes.
Conclusions:
- Neither on-pump CABG nor OPCAB demonstrated superiority regarding hospital mortality and morbidity in this patient cohort.
- While specific biochemical markers and resource utilization (ICU stay) differed, these did not translate to significant differences in major adverse events.
- The choice between on-pump and OPCAB may depend on other factors beyond mortality and major morbidity for multivessel coronary artery disease.
Abstract:
The aim of this randomised, prospective study was to evaluate hospital mortality and morbidity after myocardial revascularisation, comparing on-pump coronary artery bypass graft (CABG) myocardial revascularisation versus off-pump coronary artery bypass graft (OPCAB) myocardial revascularisation in population with multivessels coronary artery disease. Sixty patients with multivessels coronary artery diseases were scheduled to undergo coronary artery bypass grafting from January 15, 2006 to June 30, 2007 in our institution. Patients were randomized to off-pump or on-pump surgery with intermittent cross-clamping of aorta and ventricular fibrillation, using the envelope method with random numbers. In the results only difference we did find postoperatively was in Creatine Kinase-MB (CK-MB) release, the amount of bleeding and intensive care unit (ICU) stay (p<0.05). There was no diference between the two groups of patients regarding incidence of main morbidity and hospital moratlity. In summary, we didn't find no superiority in any of the two techniques regarding on hospital mortality and morbidity.
