Related Experiment Video
Updated: Oct 23, 2025
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
On-pump beating heart versus conventional on-pump coronary artery bypass grafting on clinical outcomes: a
Chen Wang1, Yefan Jiang1, Xionggang Jiang1
1Department of Cardiovascular Surgery and Heart transplantation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
On-pump beating heart coronary artery bypass graft (ON-BH CABG) shows reduced early mortality and complications compared to conventional on-pump CABG (C-CABG). Long-term survival remains similar, suggesting ON-BH CABG is a viable option, especially for high-risk patients.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Minimally Invasive Cardiac Surgery
Background:
- On-pump beating heart coronary artery bypass graft (ON-BH CABG) is an emerging technique for coronary artery revascularization.
- Conventional on-pump coronary artery bypass graft (C-CABG) is the standard surgical approach.
- Comparative outcome data for ON-BH CABG and C-CABG are crucial for clinical decision-making.
Purpose of the Study:
- To conduct a meta-analysis comparing short-term and long-term clinical outcomes of ON-BH CABG versus C-CABG.
- To evaluate the efficacy and safety of ON-BH CABG, particularly in high-risk patient populations.
Main Methods:
- A comprehensive meta-analysis of published studies was performed.
- Data from 24 studies involving 6,862 patients (1,847 ON-BH CABG, 5,015 C-CABG) were analyzed.
- Nine studies specifically focused on high-risk patients.
Main Results:
- C-CABG was associated with significantly higher risks of early mortality, myocardial infarction (MI), low output syndrome (LOS), and renal failure compared to ON-BH CABG.
- No significant difference in long-term survival was observed between the two methods.
- In high-risk patients, ON-BH CABG demonstrated lower risks of early mortality, IABP use, renal failure, hemodialysis, MI, and pulmonary complications.
Conclusions:
- ON-BH CABG may reduce postoperative mortality and complications, especially with experienced surgical teams and mature technology.
- ON-BH CABG presents an attractive alternative for high-risk patient populations undergoing coronary artery revascularization.
- Further research may explore long-term benefits and specific patient subgroups benefiting most from ON-BH CABG.
Background:
A hybrid surgery method, on-pump beating heart coronary artery bypass graft (ON-BH CABG), is supposed to be a promising technology for coronary artery revascularization. Here, we conducted a comprehensive meta-analysis of the data derived from published studies on ON-BH CABG and conventional on-pump coronary artery bypass graft (C-CABG) to compare their short-term and long-term clinical outcomes.
Methods:
We searched major electronic databases and 24 studies incorporating 6,862 patients (1,847 ON-BH CABG and 5,015 C-CABG) were included eventually, and 9 studies of them were focusing on high-risk patients.
Results:
Compared with ON-BH CABG, C-CABG was associated with a higher risk in early mortality [odds ratio (OR), 1.45; 95% confidence interval (CI), 1.09 to 1.93; P=0.01], myocardial infarction (MI) (OR, 2.60; 95% CI, 1.41 to 4.78; P<0.01), low output syndrome (LOS) (OR, 2.56; 95% CI, 1.55 to 4.23; P<0.01), renal failure (OR, 1.84; 95% CI, 1.38 to 2.44; P<0.01). In contrast, there was no significant difference in long-term survival [hazard ratio (HR), 1.08; 95% CI, 0.81 to 1.43; P=0.60]. In systematic analysis of the studies in high-risk patients, ON-BH CABG showed a lower risk in terms of early mortality, intra-aortic balloon pump (IABP) usage, renal failure, hemodialysis, MI and pulmonary complication. No significant difference was observed in the long-term survival between ON-BH CABG and C-CABG.
Conclusions:
With experienced and adept surgical team and mature ON-BH technology, ON-BH CABG may reduce the risk of postoperative death and complications in some patients. It might be an attractive alternative for high-risk patient populations.
