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Gastrointestinal ischemia related mortality in patients undergoing off- or on-pump coronary artery bypass grafting

Mustafa Emmiler1, Afsin Yaveri, Cevdet Uğur Koçoğullari

  • 1Department of Cardiovascular Surgery, Faculty of Medicine, Kocatepe University, Afyonkarahisar, Turkey. dremmiler@yahoo.com

The Heart Surgery Forum
|April 23, 2009
PubMed

Insights

Off-pump coronary artery bypass grafting (OPCAB) shows lower gastrointestinal ischemia (GII) related mortality compared to on-pump (ONCAB) surgery. This finding is crucial for reducing postoperative complications in CABG patients.

Area of Science:

  • Cardiovascular Surgery
  • Gastrointestinal Surgery
  • Surgical Outcomes

Background:

  • Gastrointestinal ischemia (GII) is a rare but severe complication following coronary artery bypass grafting (CABG).
  • Comparing outcomes between off-pump (OPCAB) and on-pump (ONCAB) CABG is essential for patient safety.
  • Understanding risk factors for GII post-CABG is critical for improving patient care.

Purpose of the Study:

  • To compare the incidence of GII in patients undergoing OPCAB versus ONCAB procedures.
  • To evaluate the impact of surgical technique on GII-related morbidity and mortality.
  • To identify potential differences in postoperative complications between OPCAB and ONCAB.

Main Methods:

  • Retrospective analysis of 2625 adult patients undergoing isolated CABG over six years.
  • Patients were divided into two groups: OPCAB (n=658) and ONCAB (n=1967).
  • Comparison of GII incidence, morbidity, and mortality rates between the two groups.

Main Results:

  • GII occurred in 0.4% of ONCAB patients and 0.2% of OPCAB patients (P=.28).
  • GII-related mortality was 0.2% in the ONCAB group versus 0% in the OPCAB group (P<.04).
  • Postoperative atrial fibrillation occurred in 100% of ONCAB patients with GII compared to 0% in OPCAB patients with GII (P<.01).

Conclusions:

  • OPCAB surgery is associated with lower GII-related mortality compared to ONCAB.
  • GII represents a significant cause of morbidity and mortality after CABG.
  • The OPCAB technique may offer a safer alternative for selected patients to reduce GII complications.
Abstract

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