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Early and Medium Outcomes of On-Pump Beating-Heart versus Off-Pump CABG in Patients with Moderate Left Ventricular

Weitie Wang1, Yong Wang1, Hulin Piao1

  • 1Department of Cardiovascular Surgery, 2nd Hospital of Bethune, Jilin University, Changchun, Jilin, China.

Brazilian Journal of Cardiovascular Surgery
|February 28, 2019
PubMed

Insights

On-pump beating-heart coronary artery bypass grafting (CABG) offers better outcomes for patients with moderate left ventricular dysfunction. This surgical technique showed improved graft numbers and ejection fraction compared to off-pump CABG, with comparable early safety.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Myocardial Revascularization

Background:

  • Patients with moderate left ventricular dysfunction (LVEF 30-40%) present unique challenges for surgical revascularization.
  • Comparing on-pump beating-heart (OPBH) and off-pump coronary artery bypass grafting (OPCABG) is crucial for optimizing patient care.

Purpose of the Study:

  • To compare the early and medium-term clinical outcomes of OPBH versus OPCABG in patients with LVEF between 30% and 40%.

Main Methods:

  • Retrospective analysis of ischemic heart disease patients (LVEF 30-40%) undergoing surgical revascularization between January 2013 and December 2017.
  • Patients were divided into OPBH (n=44) and OPCABG (n=68) groups.
  • Clinical data and early/medium outcomes were investigated and compared.

Main Results:

  • Both groups had similar baseline characteristics and in-hospital mortality.
  • OPBH patients received more grafts and showed significantly improved LVEF compared to OPCABG.
  • OPBH group had increased drainage in the first 12 hours, but no significant differences in reoperation for bleeding or ventilation duration.
  • OPBH patients demonstrated significantly lower major adverse cardiovascular events (MACE)-free survival time during medium-term follow-up.

Conclusions:

  • On-pump beating-heart CABG is a safe and acceptable alternative for patients with moderate left ventricular dysfunction.
  • OPBH provided better mid-term MACE-free survival compared to OPCABG in this patient cohort.
Abstract

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