Pulmonary outcomes of off-pump vs on-pump coronary artery bypass grafting: a prospective randomised controlled study

Background

Coronary Artery Bypass Grafting (CABG) surgery performed on Cardio- Pulmonary Bypass (CPB) may cause pulmonary dysfunction. Off Pump CABG (OPCAB) requires more expertise, but is presumed to reduce pulmonary morbidity as it alleviates the ill effects of CPB. Various studies have conflicting reports of pulmonary dysfunction with both techniques.

Methods

A single blind, prospective, randomised controlled study to detect differences in early pulmonary outcomes measured by pre-operative and post-operative pulmonary function tests in On-Pump Coronary Artery Bypass (ONCAB) vs OPCAB surgery for triple vessel disease. Patients with preoperative pulmonary dysfunction were excluded.

Results

The preoperative Pulmonary Function Test (PFT) parameters in both groups were statistically similar. Postoperative PFT in both groups (ONCAB vs OPCAB) showed reduction although statistically insignificant [FVC-58.7+/?17.5 vs 58.1+/?18.9, p?=?0.87; FEV1- 61.7+/?16.9 vs 60.28+/? 18.3, p?=?0.74; FEV1/FVC- 110+/?13.7 vs 107.4+/?11.79, p?=?0.31; PEF- 76.5+/?26.4 vs 61.8+/?22.2, p?=?0.07; F.MEP- 87.31+/?44.3 vs 74.1+/?29.2, p?=?0.28]. There was no clinical impairment in either group and ventilatory requirements were similar (13.9+/?2.6 vs 14.9+/?3.1 h; p?=?0.3).

Conclusions

Early pulmonary outcome is similar for patients without preexisting pulmonary dysfunction and undergoing elective multivessel revascularisation by ONCAB or OPCAB surgery. The hospital stay and ventilatory time were similar in both groups.