Off versus On pump coronary artery bypass grafting; a single-center experience

Ahmed Farouk; Nashwa Abdelhafez; Gamal AY Nassar; Ahmed Mandour; Mohamed Osman; Mohamed Abdelhafez

Ahmed Farouk Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
Nashwa Abdelhafez Department of Anesthesia and ICU, Faculty of Medicine, Assiut University, Assiut, Egypt
Gamal AY Nassar Metabolic and Genetic Disorders Unit, Assiut University
Ahmed Mandour Department of Anesthesia and ICU, Faculty of Medicine, Assiut University, Assiut, Egypt
Mohamed Osman Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt
Mohamed Abdelhafez Department of Cardiothoracic Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt

Keywords: Coronary artery bypass grafting, On-pump, Off-pump, Cardiopulmonary bypass

Abstract

Background: The debate about on-pump vs. off-pump coronary artery bypass grafting (CABG) continues. The present study compared the short-term outcomes after off-pump vs. on-pump CABG.

Methods: The study was conducted on 67 patients who underwent CABG from 2021 to 2022. Patients were divided into two groups according to the CABG technique. Group 1 included 33 patients who underwent off-pump CABG, and Group 2 included 34 patients who underwent on-pump CABG. The study outcomes were operative time, hospital complications, and mortality.

Results: On-pump patients were significantly older than off-pump patients (64.78±7.12 vs. 59.09±6.29; p= 0.004). There were no differences in comorbidities, presenting symptoms, or ejection fraction between groups. Operative time was significantly shorter in off-pump patients (227.47±13.73 vs. 321.12±27.49; p< 0.001). Blood transfusion was lower in off-pump patients (1.06± 0.311 vs. 1.79± 0.25; p< 0.001). Bleeding was lower in off-pump patients (0.81±0.13 vs. 0.91±0.20 ml, p= 0.01). Off-pump patients had significantly shorter ICU (3.5±2.6 vs. 4.9±4.7; p<0.001) and hospital stay (7.6±4.8 vs. 9.5±6.1; p<0.001). No patient had reexploration for bleeding, wound infection, or mortality in our series. One patient had renal impairment in the on-pump group (p>0.99).

Conclusion: Off-pump and on-pump CABG seem to be safe approaches for managing coronary artery disease in our institution. Off-pump could be superior to on-pump CABG regarding shorter ICU and hospital stay. Studies with data from a large number of patients are recommended.