Related Experiment Video
Updated: Jan 1, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Mortality and Readmissions After On-Pump Versus Off-Pump Redo Coronary Artery Bypass Surgery
Edgar Aranda-Michel1, Valentino Bianco1, Arman Kilic2
1Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, United States of America.
Insights
For redo coronary artery bypass grafting (CABG), neither on-pump nor off-pump techniques offered a survival advantage. However, off-pump CABG was associated with higher 5-year hospital readmissions, despite no significant difference in mortality.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Cardiac Surgery
Background:
- Existing research extensively compares on-pump versus off-pump coronary artery bypass grafting (CABG) in first-time procedures.
- However, limited literature addresses the outcomes of off-pump versus on-pump strategies specifically for patients undergoing redo CABG.
Purpose of the Study:
- To compare the short-term and long-term outcomes of on-pump versus off-pump redo CABG.
- To identify factors associated with 5-year mortality and readmission after redo CABG.
Main Methods:
- A retrospective study included all patients who underwent redo CABG between 2011 and 2017.
- Cox regression analysis was employed to determine variables linked to 5-year mortality and readmission.
Main Results:
- Of 350 redo CABG patients, 309 had on-pump and 41 had off-pump procedures.
- The on-pump group showed higher rates of blood product transfusion and new-onset atrial fibrillation.
- No significant differences were observed in 30-day, 1-year, or 5-year mortality between the on-pump and off-pump redo CABG groups.
- While 30-day and 1-year readmissions were similar, 5-year all-cause readmissions were significantly higher in the off-pump group.
- Multivariable analysis indicated no significant association between on-pump versus off-pump CABG and 5-year mortality or readmission.
Conclusions:
- On-pump versus off-pump redo CABG did not demonstrate a short-term or long-term survival advantage, even after risk adjustment.
- The off-pump redo CABG cohort experienced a higher rate of 5-year hospital readmissions.
Introduction:
Large institutional and administrative datasets that have compared on pump versus off pump first time coronary artery bypass grafting (CABG). However, comparison of off-pump vs on-pump outcomes in patients undergoing redo CABG are limited in current literature.
Methods:
All patients who underwent redo CABG for coronary artery disease from 2011 to 2017 at our institution were included in the study. Cox regression analysis was performed to identify variables associated with 5-year mortality and readmission.
Results:
Three hundred and fifty patients underwent redo CABG; of which, 309 underwent on-pump CABG and 41 underwent off-pump CABG. Blood product transfusion (31.7% vs 58.9%; p = 0.001) and new onset atrial fibrillation (17.1% vs 35.6%; p = 0.018) were higher in the on-pump cohort. There was no difference in 30-day (2.4% vs 8.1%; p = 0.209), 1-year (4.9% vs 16.5%; p = 0.074), or 5-year mortality (31.7% vs 35.6%; p = 0.213) for off vs on pump redo CABG. There was no difference in 30-day or 1- hospital readmissions between groups. Five-year all cause readmissions (76.9% vs 55.3%; p = 0.037) was significantly higher in the off-pump redo CABG group. On multivariable analysis, on vs. off pump CABG was not significantly associated with mortality or readmission at 5 years.
Conclusion:
There was no short or long-term survival advantage for on-pump vs off-pump CABG despite risk adjustment. Hospital readmissions at 5-years were higher in the off-pump group.
More Related Videos
Related Concept Videos
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:27Coronary Artery Disease V: Interprofessional Care