Off-Pump Coronary Artery Bypass Grafting Improves Early Clinical Outcomes Including Operative Mortality.

Area of Science:

• Cardiovascular Surgery
• Cardiac Surgery Outcomes
• Minimally Invasive Cardiac Surgery

Background:

• The choice between on-pump and off-pump coronary artery bypass grafting (CABG) remains debated.
• This study presents long-term clinical outcomes and adverse events of off-pump CABG.

Purpose of the Study:

• To evaluate the safety and efficacy of off-pump CABG.
• To analyze clinical outcomes and adverse events over time in a large cohort.

Main Methods:

• Analysis of 4310 isolated off-pump CABG patients from 2002-2016.
• Data collected prospectively, including preoperative, intraoperative, and postoperative details.
• Patients grouped into three 5-year periods to assess changes over time; quality control monitoring applied.

Main Results:

• Postoperative mortality was 0.7%, with low rates of acute renal failure (0.2%), stroke (0.2%), and mediastinitis (1.2%).
• Despite a worsening patient risk profile, mortality significantly improved over the study period.
• Adverse event rates for stroke, renal failure, and mediastinitis remained stable; 30-day mortality or conversion rate is 0.5%.

Conclusions:

• Off-pump CABG is a safe and effective surgical option.
• The procedure demonstrates superior results compared to on-pump CABG, especially when performed by specialized surgeons.