Comparison of On-Pump Beating Heart Surgery Versus Conventional Bypass Surgery in Patients with Acute Myocardial Infarction Requiring Urgent Revascularization

Background: The objective of our study was to provide the initial outcomes of the traditional coronary artery surgery approach and the on-pump beating heart surgery in terms of survival and morbidity in patients who needed emergency surgery for acute myocardial infarction. Methods: A single-center retrospective study was performed from November 2013 to September 2023 on a total of 212 patients requiring emergency coronary artery surgery. Group I patients (n = 108) received traditional coronary artery bypass grafting with cross-clamping, while Group II patients (n = 104) underwent on-pump coronary surgery on the beating heart. Results: There were no disparities observed in the preoperative left ventricular function, percutaneous coronary intervention, intra-aortic balloon usage, or clinical-hemodynamic characteristics. Group I patients had significantly higher rates of postoperative mortality and low cardiac output syndrome, as well as a greater utilization of intra-aortic balloons and a higher requirement for extracorporeal membrane oxygenation (p < 0.001). Conclusions: Ultimately, the on-pump beating heart approach could serve as a viable alternative to enhance the preservation of cardiac function and decrease postoperative complications and mortality rates in patients with acute myocardial infarction who require emergency surgery.