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Does multi-vessel off-pump coronary artery bypass grafting reduce post operative morbidity compared to on-pump CABG?

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Abstract

Background

Cardiopulmonary bypass (CPB) may contribute to the complications and it is assumed that eliminating cardiopulmonary bypass has the potential of reducing post operative morbidity after coronary artery bypass grafting (CABG). The study was carried out to compare mortality and morbidity in the off-pump and on-pump CABG groups.

Methods

We prospectively analysed 200 patients undergoing CABG. Group A consists of 100 patients underwent multi-vessel off-pump CABG and group B consists of 100 patients underwent CABG with CPB. The incidence of complications (mortality, re-exploration for bleeding, myocardial infarction, atrial fibrillation, neurological events, new onset renal failure (s. creatinine>1.6 mg/dL) pulmonary complications, length of ICU stay and hospital stay were recorded, analysed and compared.

Results

OPCAB patients received 2.73±0.61 grafts/patient and on-pump CABG patients received 3.39±0.75 grafts/patient (p value<0.00001). There was no significant statistical difference in mortality, incidence of stroke between OPCAB and CABG with CPB patients. Length of ICU stay was 32.84±4.22 vs 44.85±7.18 hrs (p value<0.00001) and hospital stay was 6.52±0.69 vs 7.94±0.92 days (p value<0.00001) between group A and group B respectively. Incidence of atrial fibrillation was less in OPCAB group 7% vs 12% although it was statistically not significant (p value 0.33). It was observed in our study that there was no significant deference in worsening of existing renal failure between on-pump CABG and OPCAB 6% vs 2% (P value 0.28). Blood utilization was significantly less in OPCAB group (p value<0.001).

Conclusion

There was no statistically significant difference in terms of mortality, incidence of stroke and new onset renal failure in both groups. But there was lesser incidence of post operative atrial fibrillation, worsening of existing renal failure in off-pump group though statistically not significant. There was significant reduction in blood utilization, length of ICU and hospital stay in OPCAB group.

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Authors and Affiliations

  1. Division of Cardiothoracic Surgery, Care Hospital, The Institute of Medical Sciences, Road No. 1, Banjara Hills, 500 004, Hyderabad

    Lokeswara Rao Sajja M.Ch,  Gopichand Mannam FRCS & Karri Venkata Reddy M.Ch.

  2. Division of Cardiology, Care Hospital, The Institute of Medical Sciences, Road No. 1, Banjara Hills, Hyderabad

    Bhupathiraju Soma Raju DM & Penmetcha Krishnam Raju DM

  3. Division of Cardiothoracic Anesthesiology, Care Hospital, The Institute of Medical Sciences, Road No. 1, Banjara Hills, Hyderabad

    Sriramulu Sompali MD & Bala Raju Ravirala DNB

Authors
  1. Lokeswara Rao Sajja M.Ch
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  2. Gopichand Mannam FRCS
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  3. Sriramulu Sompali MD
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  4. Karri Venkata Reddy M.Ch.
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  5. Bala Raju Ravirala DNB
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  6. Bhupathiraju Soma Raju DM
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  7. Penmetcha Krishnam Raju DM
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Correspondence to Gopichand Mannam FRCS.

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Sajja, L.R., Mannam, G., Sompali, S. et al. Does multi-vessel off-pump coronary artery bypass grafting reduce post operative morbidity compared to on-pump CABG?. Indian J Thorac Cardiovasc Surg 20, 173–177 (2004). https://doi.org/10.1007/s12055-004-0080-1

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  • DOI: https://doi.org/10.1007/s12055-004-0080-1

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