Related Experiment Video
Updated: Mar 25, 2026
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Is off-pump technique a safer procedure for coronary revascularization? A propensity score analysis of 20 years of
Paula Carmona1, Federico Paredes2, Eva Mateo3
1Department of Cardiovascular-Anesthesia and Intensive Care, University Hospital La Fe, Valencia, Spain.
Insights
Off-pump coronary artery bypass grafting (CABG) shows reduced postoperative complications and shorter hospital stays compared to on-pump CABG. Long-term survival rates were similar between the two surgical approaches.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a standard procedure for treating coronary artery disease.
- The choice between on-pump (using cardiopulmonary bypass) and off-pump CABG techniques impacts patient outcomes.
- Understanding comparative morbidity and mortality is crucial for surgical decision-making.
Purpose of the Study:
- To compare intraoperative and postoperative outcomes between on-pump CABG (ONCABG) and off-pump CABG (OPCABG).
- To identify predictors of morbidity and mortality in patients undergoing CABG.
Main Methods:
- A retrospective analysis of 3097 patients undergoing CABG between 1993 and 2013.
- 1004 matched pairs of ONCABG and OPCABG patients were selected using propensity score matching.
- Univariable and multivariable logistic regression analyses were used to assess outcomes.
Main Results:
- OPCABG was associated with significantly lower rates of cardiovascular, neurological, and respiratory complications compared to ONCABG.
- Hospital and intensive care unit lengths of stay were shorter for OPCABG patients.
- No significant difference was observed in 30-day or long-term all-cause mortality between the groups.
Conclusions:
- Off-pump CABG is linked to reduced postoperative morbimortality and shorter hospital stays.
- On-pump CABG emerged as an independent predictor of composite morbidity and mortality endpoints.
- Long-term survival does not differ significantly between ONCABG and OPCABG.
Objectives:
We aim to describe our experience in coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass by comparing intraoperative and postoperative outcomes.
Methods:
From January 1993 to June 2013, 3097 patients underwent consecutive emergency and scheduled CABG surgery. A total of 1770 patients underwent on-pump CABG (ONCABG) and 1327 off-pump CABG (OPCABG). A propensity score matching was performed to identify appropriate matched-pair patients; univariable and multivariable logistic regression analyses were performed to assess significant predictors of hospital and 30-day morbidity and mortality composite end-points. Morbidity composite end-point was defined as any renal, pulmonary, cardiovascular and neurological complication that occurred during hospital stay. We collected all-cause mortality data during the study period.
Results:
We identified 1004 patients in each group. There were no significant differences in thirty day mortality, 2.8 vs 3.8%, in OPCABG and ONCABG, respectively (P = 0.21). Cardiovascular, neurological, respiratory and renal complications were more frequent in the ONCABG group: 13.9 vs 8.7% (P < 0.001), 3.9 vs 2.2% (P = 0.03), 13.5 vs 7.5% (P < 0.001), 7.1 vs 5.3% (P = 0.095), respectively. The long-term all-cause mortality rate was 12.3 vs 12.9% in the OPCABG versus ONCABG group (P = 0.42), respectively. In both uni- and multivariable analysis preoperative renal failure, chronic obstructive pulmonary disease and ONCABG were independent predictors of mortality and morbidity composite end-points.
Conclusions:
OPCABG is associated with less postoperative morbimortality and shorter hospital and intensive care unit length of stay. ONCABG resulted as an independent predictor of morbidity and mortality composite end-point. No statistically significant differences were observed in long-term all-cause mortality between groups.
More Related Videos
09:12Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
12:00Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014