The Comparison of Clinical Study of Off Pump and On Pump CABG

Yoo, Kyung Jong; Lim, Sang Hyun; Song, Suk Won; Kim, Chi Young; Hong, You Sun; Chang, Byung Chnl

Abstract

BACKGROUND: In an attempt to avoid the adverse effects of the cardiopulmonary bypass, off pump coronary artery bypass grafting(Off pump CABG) that has recently been rediscovered and refined. We compared the preoperative risk factors and in-hospital outcomes of patients done Off pump with those done On pump CABG. MATERIAL AND METHOD: One hundred seventy eight patients was underwent CABG between January 2001 and July 2001. 12 patients whom underwent associated valvular or left ventricular volume reduction surgery were excluded in this study. Data were collected for 52 Off pump CABG and 114 On pump CABG for patient and disease risk factors, extent of coronary disease, and in-hospital outcomes. RESULT: Off pump CABG and On pump CABG groups did not show any differences in their patient and disease risk factors, and extent of coronary disease. Off pump CABG group had significantly lower mean operation time(234 +/- 37 min vs 290 +/- 48 min, p < 0.001), lower mean CK-MB level(10.1 +/- 13.5 IU/L vs 33.1 +/- 18.2 IU/L, p < 0.001) and mean ventilation time(14.8 +/- 3.5 hours vs 16.2 +/- 4.9 hours, p=0.048) than On pump CABG groups. On pump CABG group had significantly more distal grafts(3.4 +/- 0.9 vs 2.6 +/- 0.8, p < 0.001) than Off pump CABG groups. There were no operative mortality in two groups. Off pump CABG and On pump CABG groups did not show any differences in their postoperative complications and outcomes including perioperative myocardial infarction, stroke, respiratory failure, renal failure, reoperation, the amount of bleeding, the need of intraaortic balloon pump, the need of inotropics, and the stay of intensive care unit and hospital. Two patients were converted to On pump CABG.
CONCLUSION
This study showed that patients having Off pump CABG are not exposed to a greater risks of adverse outcomes and also provided evidence that patients having Off pump CABG have significantly lower operation time, CK-MB, ventilation time and less distal grafts. Although there may be potential benefits to Off pump CABG, further studies must be directed to determine those patients who would benefit from Off pump CABG.