Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2003 April;44(2) > The Journal of Cardiovascular Surgery 2003 April;44(2):167-72

CURRENT ISSUE
 

JOURNAL TOOLS

Publishing options
eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions
Share

 

CARDIAC SECTION  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2003 April;44(2):167-72

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Off-pump versus on-pump coronary bypass. Comparison of patient characteristics and early outcomes

Järvinen O., Laurikka J., Tarkka M. R.

Department of Cardiothoracic Surgery Tampere University Hospital, Tampere, Finland


PDF


Aim. ­This clin­ical ­report ­details a com­par­ison ­between the con­ven­tional on-­pump and ­beating ­heart off-­pump tech­niques ­with par­tic­ular atten­tion to ­patient char­ac­ter­is­tics, per­i­op­er­a­tive var­i­ables and ­early out­comes.
­Methods. We col­lected pros­pec­tively a com­pre­hen­sive ­data ­body ­from 1131 con­sec­u­tive ­patients who under­went iso­lated ­CABG in Tam­pere Uni­ver­sity Hos­pital. The mor­bidity, mor­tality and ­length of ­stay ­data ­from the sec­on­dary ­referral hos­pi­tals ­were ­also col­lected. One thou­sand and six­teen (89.8%) ­patients under­went ­bypass ­grafting ­with car­di­o­pul­mo­nary ­bypass (CPB, on-­pump) and 115 (10.2%) ­patients ­without the CPB (off-­pump).
­Results. ­Thirty-day mor­tality ­rates ­were 4.0% (on-­pump) and 2.6% (off-­pump, p=0.5). The ­total post­op­er­a­tive ­length of ­stay was 12 (on-­pump) and 10 (off-­pump) ­days as the ­medians (p<0.001). ­Adverse out­come ­events ­among the on-­pump and off-­pump ­patients ­were as fol­lows: post­op­er­a­tive ­stroke, 2.5% and 0.9% (p=0.3); per­i­op­er­a­tive myo­car­dial infarc­tion, 7.0% and 7.8% (p=0.7); ­impaired ­renal func­tion, 9.5% and 4.3% (p=0.3); re-ster­notomy for ­bleeding or low ­output, 5.3% and 4.3% (p=0.2); new-­onset ­atrial fib­ril­la­tion, 38.9% and 24.6% (p=0.002) and the ­need for red ­cell trans­fu­sions in ICU, 50.3% and 22.6% (p<0.001). ­Eighty-­three percent of the on-­pump and 85.2% of the off-­pump ­patients (p=0.5) had a favor­able out­come ­without a ­major com­pli­ca­tion.
Con­clu­sion. Con­sid­ering the lim­i­ta­tions ­with a non­ran­dom­ized ­study ­design, we con­clude ­that off-­pump ­CABG is a ­safe and com­par­able ­method of myo­car­dial revas­cu­lar­iza­tion in ­terms of ­early out­comes. ­Overall ­length of ­stay ­shorter by 2 ­days, ­over a ­third ­shorter ven­ti­la­tion ­time, ­fewer red ­cell trans­fu­sions and ­lower fre­quency of post­op­er­a­tive ­atrial fib­ril­la­tion ­favor off-­pump sur­gery.

top of page