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Early outcome of off-pump versus on-pump coronary revascularization


Saeed Davoodi
Abbasali Karimi
Seyed Hossein Ahmadi
Mehrab Marzban
Namvar Movahhedi
Kyomars Abbasi
Abbas Salehi Omran
Mahmood Shirzad
Mehrdad Sheikhvatan
Seyed Hesameddin Abbasi
Payvand Bina

Abstract

Introduction: The use of coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB) or without CPB technique (off-pump) can be associated with different mortality and morbidity and their outcomes remain uncertain. The goal of this study was to evaluate the early outcome of on-pump versus off-pump CABG.

Methods: We conducted a retrospective database review of 13866 patients (13560 patients undergoing onpump CABG and 306 patients undergoing off-pump CABG) at Tehran Heart Center between January 2002 and January 2007. We compared preoperative, operative, and postoperative  characteristics between them.

Results: In-hospital mortality in the on-pump group was 0.8% compared to 0.7% in the off-pump group (P=0.999) and in-hospital morbidity was 11.7% and 6.5%, respectively  (OR: 1.533, 95%CI: 0.902-2.605, P=0.114). Postoperative atrial fibrillation was more prevalent in on-pump versus off-pump surgery (6.0% vs 3.0%, P=0.028), however there were no statistical significant differences in other postoperative   complications with regard to cardiac arrest (P=0.733), prolonged ventilation (P=0.363), brain stroke   (P=0.999), renal failure (P=0.525), and postoperative bleeding (P=0.999). The mean length of stay in hospital (P=0.156) and in ICU (P=0.498) was also similar between the two groups.

Conclusion: The results from an Iranian population-based study showed similar early mortality and morbidity of off-pump CABG in comparison to on-pump surgery.

Key words: Coronary artery bypass grafting, Off-pump, Cardiopulmonary bypass, Outcome


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eISSN: 1937-8688