Retrospective observational analysis of a coronary artery bypass grafting surgery patient cohort: Off-pump versus on-pump. (December 2022)

• Record Type: Journal Article
• Authors: Rantanen, Matias; Yousif, Rizgar; Kallioinen, Minna; Hynninen, Ville-Veikko; Peltoniemi, Marko; Söderholm, Oki; Saarikoski, Tuukka; Anttila, Vesa; Aittokallio, Jenni
• Is Part Of: Annals of medicine and surgery. Volume 84(2022)
• Publication Date: 2022-12
• Subjects: Coronary artery bypass grafting -- Off-pump -- On-pump; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104812
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Objectives: To determine whether surgical technique has an effect on prognosis in coronary artery bypass grafting (CABG). Design: Retrospective observational. Setting: Single center. Participants: All the off-pump (OPCABG) and on-pump (ONCABG) patients at Turku University Central Hospital in 2018. Interventions: None. Measurements and main results: After propensity score matching, perioperative, 1-year and 3-year mortality did not differ between the groups. The ONCABG patients received more allogenic red blood cells (1.3 vs. 0.6 units, p = 0.020), autologous red blood cells (564 vs. 285 ml, p < 0.001) and crystalloids (3388 vs. 2808 ml, p < 0.001), and had higher postoperative values of troponin T (581 vs. 222, p = 0.001) and lactate (1.69 vs. 1.23, p < 0.001) than the OPCABG patients. Conclusions: The both techniques seem equally safe. However, there may be some benefits to avoiding using a heart-lung machine, such as lower infused fluid volumes. Myocardial damage may also be milder and postoperative hemodynamics more balanced in OPCABG patients, based on lower levels of troponin T and lactate. Highlights: Coronary artery bypass grafting (CABG) can be performed with on-pump (ONCABG) or off-pump (OPCABG) methods, with ONCABG being more common. OPCABG complicates the technical performance as it is made with beating heart. ONCABG, on the other hand, requires the use of a heart-lung machine. We studied retrospectively all the OPCABG and ONCABG patients at Turku University Central Hospital in 2018. The both techniques seem equally safe. However, OPCABG patients received lower amounts of blood products, and had lower troponin-T and lactate.