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Off-pump versus on-pump coronary artery revascularization: effects on pulmonary function.

Ana M R P e Silva1, Roberto Saad, Roberto Stirbulov

  • 1Department of Surgery, Santa Casa de São Paulo, Faculty of Medical Sciences, São Paulo, Brazil. ana.mrp@uol.com.br

Interactive Cardiovascular and Thoracic Surgery
|April 21, 2010
PubMed
Summary

Off-pump coronary artery surgery patients experienced significantly better lung function recovery compared to on-pump surgery patients. This suggests cardiopulmonary bypass impacts pulmonary function differently during cardiac procedures.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Pulmonary Medicine

Background:

  • Coronary artery bypass grafting (CABG) surgery often leads to changes in lung function.
  • The comparative recovery profiles of off-pump versus on-pump CABG regarding pulmonary function remain debated.

Purpose of the Study:

  • To prospectively compare pulmonary function recovery in patients undergoing off-pump CABG with an intraluminal shunt versus on-pump CABG.
  • To evaluate the impact of cardiopulmonary bypass on postoperative lung function.

Main Methods:

  • A prospective study of 42 patients undergoing CABG, divided into off-pump (n=21) and on-pump (n=21) groups, matched for lesion location.
  • Patients underwent spirometry, blood gas analysis, and alveolo-arterial oxygen gradient (A-aDO(2)) measurements on postoperative days 4 and 10.
  • Preoperative pulmonary function was assessed to ensure group comparability.

Main Results:

  • Both groups showed decreased spirometry, reduced PaO(2) and PaCO(2), and increased A-aDO(2) postoperatively.
  • Off-pump patients demonstrated significantly better spirometric improvement compared to on-pump patients by postoperative day 10.
  • Pulmonary function changes differed between the two surgical approaches.

Conclusions:

  • Coronary artery surgery significantly affects lung function postoperatively, regardless of the technique.
  • Off-pump CABG with an intraluminal shunt is associated with superior pulmonary function recovery compared to on-pump CABG.
  • The use of cardiopulmonary bypass appears to have a more pronounced negative impact on lung function recovery.