Open AccessOff pump vs on pump coronary artery bypass grafting: Perioperative complications and early clinical outcomes
Author(s) -
Ahmed El Naggar,
Maged Abou El Magd,
Rania El Hoseiny,
Yehya Mohamed
Publication year - 2012
Publication title -
the egyptian heart journal /the egyptian heart journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.212
H-Index - 9
eISSN - 2090-911X
pISSN - 1110-2608
DOI - 10.1016/j.ehj.2011.08.014
Subject(s) - medicine , perioperative , off pump coronary artery bypass , incidence (geometry) , artery , atrial fibrillation , surgery , cardiology , anesthesia , mechanical ventilation , bypass grafting , optics , physics
AbstractBackground: Off pump coronary artery bypass grafting (OPCABG) is gaining world wide acceptance as the preformed choice for myocardial revascularization. However, no definite data exist as to whether it is better than conventional coronary artery bypass grafting (CABG).Objective: We aimed to compare the incidence of complications and early outcomes between the conventional CABG and OPCABG.Methods: Between October 2007 and April 2008, 40 patients underwent CABG, 30 pts had been subjected to OPCABG (group I) and 10 pts underwent pump surgery (group II). Analysis of in hospital mortality, perioperative and postoperative courses and clinical outcomes were performed.Results: The perioperative data showed that on pump group exhibited significant higher number of grafts/pt (2.6±0.9 vs 1.5±0.6, P: 0.05), higher incidence of arterial grafts (73% vs 10%, P<0.05) more blood loss (1300±650ml vs 750±550ml, P<0.05) and more need for colloid and crystalloid transfusions (1250±480ml and 2100±450ml vs 550±350ml and 1300±250ml, P<0.05) as compared to off pump group, respectively. In addition, the incidence of postoperative atrial fibrillation is higher in on pump as compared to off pump group (70% vs 10%, P<0.001), respectively. The incidence of pts who need prolonged mechanical ventilation (>6h), was also higher in on pump as compared to off pump group (50% vs 3.3%, P<0.001). The overall incidence of postoperative complications including acute renal failure, MI, wound infection, and duration of hospital stay are also higher in on pump group as compared to OPCABG.Conclusion: Off pump CABG is safe and associated with good clinical outcome and can be considered alternative to conventional CABG as treatment modality for surgical coronary revascularization but this will need large scale study to establish this technique