Cardiopulmonary Bypass-Supported Coronary Artery Bypass Surgery: A Flexible and Effective Alternative to Off-Pump...

Area of Science:

• Cardiac Surgery
• Cardiovascular Medicine
• Surgical Outcomes Research

Background:

• Coronary artery bypass grafting (CABG) is a cornerstone treatment for coronary artery disease.
• Both off-pump coronary artery bypass (OPCAB) and cardiopulmonary bypass-supported beating-heart coronary artery bypass grafting (CPB-BH CABG) are established surgical techniques.
• Comparative early postoperative outcomes between CPB-BH CABG and OPCAB require further elucidation.

Purpose of the Study:

• To compare the early postoperative outcomes of CPB-BH CABG versus OPCAB surgery.
• To evaluate differences in mortality, major complications, revascularization rates, and hospital stay between the two techniques.

Main Methods:

• Retrospective analysis of 589 patients undergoing beating-heart CABG between October 2021 and January 2025.
• Patients were divided into two groups: CPB-BH CABG (n=177) and OPCAB (n=412).
• Primary outcomes included mortality and major complications; secondary outcomes included revascularization, operative time, hospital stay, and transfusion needs.

Main Results:

• No significant differences in preoperative characteristics were observed between the groups.
• CPB-BH CABG group exhibited longer operative times (268.7 vs. 223.6 min) and hospital stays (7 vs. 5 days) (p < 0.001).
• Higher rates of blood transfusion (p < 0.001) and new-onset atrial fibrillation (33.9% vs. 24.0%, p = 0.016) were noted in the CPB-BH group; revascularization rates were comparable.

Conclusions:

• CPB-BH CABG is a viable alternative to OPCAB, providing similar revascularization outcomes.
• The flexibility of cardiopulmonary bypass support can be utilized when necessary to optimize surgical results.
• Prospective randomized trials are recommended to assess long-term outcomes and effectiveness in specific patient subgroups.