The In-hospital Analysis of Outcome of Off-pump CABG and On-pump CABG

Kim, Woo Shik; Ahn, Jae Bum; Kim, In Sub; Jung, Sung Chul; Bae, Yoon Sook; Yoo, Hwan Kook; Kim, Byung Yul

Abstract

Background
With the developement of non-invasive surgical techeniques, coronary artery bypass graft without cardiopulmonary bypass has become popular. We compared the preoperative risk factors and in-hospital outcomes of patients having off-pump CABG with those having on-pump CABG. Material and Method: From January 2001 to June 2003, 87 patients underwent CABG. Thirty-six patients underwent on-pump CABG, fifty-one patinents underwent off-pump CABG. Preoperative risk factors, extent of coronary disease, operative time, postoperative endotracheal intubation time, duration of ICU stay & hospital stay, the amount of bleeding and postoperative levels of cardiac enzymes were compared in both groups. Result: There were no differences in their sex ratios, ages, preoperative risk factors, preoperative MI, Canadian classes, extent of coronary artery diseases and, echocardiographic ejection fraction between Off-pump CABG and On-pump CABG groups. Off-pump CABG group had significantly lower mean operative time (270+/-79.3 min vs 372+/-142.2 min, p<0.001), mean ventilation time (17.1+/-13.1 hr vs 24.3+/-17.8 hr) and CK-MB level (8.9+/-18.7 IU/L vs 25.7+/-8.4 IU/L) than on-pump CABG groups. On-pump CABG group had more distal grafts (2.2+/-0.5 vs 1.7+/-0.7) than Off-pump CABG groups did. There were no differences in their postoperative complications and outcomes including amount of postoperative bleeding for 24 hrs, reoperation for bleeding control, mean in-hospital days, postoperative infection, renal failure and neurologic complications between Off-pump CABG and On-pump CABG groups.
Conclusion
This study showed that patients who underwent Off-pump CABG had less operation time & intubation time and lower CK-MB level; however, they also have less distal graft. Even though CABG without CPB provided satisfactory results, more clinical experience & longer follow-up is required.