Comparison of Early Postoperative Complications between On-Pump and Off-Pump Coronary Artery Bypass Grafting

Abstract

Background: Coronary artery bypass grafting (CABG) remains one of the finest surgical techniques for treating severe coronary artery disease. Traditional on pump CABG is still widely in use but off-pump CABG has gained popularity as a substitute method to reduce the side effects of cardiopulmonary bypass. The superiority of either strategy in terms of clinical results and postoperative complications, however, is still up for debate.

Aim of the Study: To assess the prevalence and predictors of early postoperative complications in patients receiving on-pump versus off-pump CABG.

Patients and Methods: This prospective observational cohort study was conducted at the Cardiothoracic Surgery Department, National Heart Institute, Cairo, Egypt, and Shebein Elkom Teaching Hospital, Shebein Elkom, Menoufia, Egypt on 120 patients receiving isolated CABG who were divided equally into two groups: the off-pump CABG group and the on-pump CABG group.

Results: On-pump CABG was related with prolonged operating time, mechanical ventilation, ICU and hospital stay. The unadjusted rate of patients with at least 1 postoperative complication was greater in the on-pump group. There were no statistically significant between-group differences in postoperative atrial fibrillation, myocardial infarction, stroke or transient ischaemic attack, acute renal injury, bleeding necessitating re-exploration, or 30-day mortality.

Conclusion: Off-pump CABG was associated with shorter mechanical ventilation duration, ICU stay, and hospital stay and with a lower unadjusted incidence of the composite outcome of any early postoperative complication. However, the two techniques showed no statistically significant differences in individual major complications or 30-day mortality.