Short term outcome of conventional versus off-pump coronary artery bypass grafting for high-risk patients

Background

Off-pump coronary artery bypass grafting (OPCAB), avoiding the use of cardiopulmonary bypass, has attracted the interest of an increasing number of surgeons and patients, and has assumed an increasing role in surgical practice. Whether OPCAB have better outcome in high-risk patients as compared to Conventional coronary artery bypass grafting (C-GABG) remains to be confirmed. We describe an analysis of early clinical outcomes of high-risk coronary artery disease (CAD) patients, subjected to both techniques.

Methods

We studied 450 patients with additive EuroSCORE of ≥5 on admission. Patients were divided into 2 groups; Group A was assigned for patients underwent conventional C-CABG, and Group B for patients underwent OPCAB. Data, including gender, age, demographic variables and postoperative complications were extracted from the medical records.

Results

Both groups were matched with regard to age, gender, smoking, Diabetes mellitus, dyslipidemia, renal hemodialysis and the mean Euro-Score. We demonstrated a decrease in the incidence of early postoperative atrial fibrillation and renal failure in the Off-pump group. However, we recorded no statistical difference of neurologic complications, acute myocardial infarction or early mortality between the two groups.

Conclusions

We recommend OPCAB in high-risk CAD patients, as this technique may carry potential benefits without compromising their clinical outcomes.