Comparative study of on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease

Minimalinvasivesurgeryhasbecomepopularsince2 0thcentury .Withregardtocoronaryarterybypasssurgery,avoidingcardiopulmonarybypass(CPB)hasavitalsignificanceoftheminimalinvasivesurgery ,foritcanavoidtheischemia reperfusioninjuryandaseriesofpathophysiologicaldisordersoftheorgansbroughtbytheCPB .SinceBenettiandBuffolo[1-2 ] firstreportedtheirexperiencesofoff pumpCABG ,(OPCAB) ,quiteafewliteratureshavecomparedtheeffectbetweenOPCABandconventionalon pumpCABG (CCABG ) .Forthedifferenceofpatie…

Comparative study of on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease

Objective To compare the clinical results of on-pump and off-pump coronary bypass surgery in patients with triple-vessel disease. Methods A total of 300 consecutive isolated multiple CABG patients entered into off-pump coronary artery bypass (OPCAB group, n=150) or CABG with cardiopulmonary bypass (CPB) (CCABG group, n=150). There were no significant difference regarding the degree of angina, history of myocardial infarction, diabetes and left main disease between two groups. The ejection fraction in OPCAB before surgery was lower than CCABG (P<0.01). More patients had a history of stroke, and abnormal renal function in OPCAB pre-operatively( P< 0.01 ). Single deep pericardial stay suture with a sling snared down was used to expose the target vessels in OPCAB, along with a stabilizer and a coronary shunt. Medi-Stim Butterfly Flowmeter was used to measure the flow of grafts in both groups. Results No one in OPCAB needed to convert to CCABG. The number of the distal anastomosis and the index of completeness of revisualization (ICR) were similar in both groups. The respiratory support time, the volume of chest tube drainage and blood transfusion were less in OPCAB than in CCABG post-operatively (both P<0.01). The incidence of pulmonary dysfunction and renal insufficiency were less in OPCAB than in CCABG post-operatively ( both P<0.05 ) . There was no significant difference in the mortality and other morbidities (peri-opetative MI, stroke, atrial fibrillation). Conclusion OPCAB can be applied to patients with triple vessels disease and achieved similar completeness of revascularization, similar early surgical results with shorter respiratory support, reduced transfusion requirement, less pulmonary dysfunction and abnormal renal function.