Abstract
Background The current study analyzed and compared early-term outcomes of off-pump versus on-pump
beating heart coronary artery bypass surgery.
Methods From January 2011 to January 2018, a total of 736 patients underwent isolated first-time
elective beating-heart coronary artery bypass surgery without the use of aortic cross-clamping
and cardioplegic arrest at our institution, and they were included in this study.
Data of patients were collected and retrospectively analyzed. Patients were divided
into two groups according to the use of cardiopulmonary bypass during the operation,
as off-pump group (n = 399) and on-pump beating-heart group (n = 337). Both groups were compared with each other in terms of preoperative, intraoperative,
and postoperative data.
Results Groups were statistically similar with regard to baseline clinical characteristics
and demographics. When compared with off-pump group, on-pump beating-heart group had
a greater number of distal bypass, longer length of hospital stay, and lower postoperative
hematocrit level, and received more blood product transfusion. No statistically significant
differences were detected between the groups with respect to mortality and postoperative
complications except for atrial fibrillation. Atrial fibrillation was significantly
frequent in on-pump beating-heart group.
Conclusion Our study suggested that off-pump and on-pump beating-heart coronary artery bypass
procedures had similar early mortality and major complication rates except for atrial
fibrillation. However, it seemed that off-pump procedure was superior to on-pump beating-heart
procedure with regard to length of hospital stay, blood product transfusion, and atrial
fibrillation development. Further prospective randomized studies with larger patient
series are needed to support our research and attain more accurate data.
Keywords
coronary artery bypass grafting - cardiopulmonary bypass - off-pump surgery - outcomes
