Off pump vs on pump coronary artery bypass grafting: Perioperative complications and early clinical outcomes

Background: Off pump coronary artery bypass grafting (OPCABG) is gaining world wide acceptance as the preformed choice for myocardial revascularization. However, no definite data exist as to whether it is better than conventional coronary artery bypass grafting (CABG).Objective: We aimed to compare the incidence of complications and early outcomes between the conventional CABG and OPCABG.Methods: Between October 2007 and April 2008, 40 patients underwent CABG, 30 pts had been subjected to OPCABG (group I) and 10 pts underwent pump surgery (group II). Analysis of in hospital mortality, perioperative and postoperative courses and clinical outcomes were performed.Results: The perioperative data showed that on pump group exhibited significant higher number of grafts/pt (2.6 ± 0.9 vs 1.5 ± 0.6, P: 0.05), higher incidence of arterial grafts (73% vs 10%, P < 0.05) more blood loss (1300 ± 650 ml vs 750 ± 550 ml, P < 0.05) and more need for colloid and crystalloid transfusions (1250 ± 480 ml and 2100 ± 450 ml vs 550 ± 350 ml and 1300 ± 250 ml, P < 0.05) as compared to off pump group, respectively. In addition, the incidence of postoperative atrial fibrillation is higher in on pump as compared to off pump group (70% vs 10%, P < 0.001), respectively. The incidence of pts who need prolonged mechanical ventilation (>6 h), was also higher in on pump as compared to off pump group (50% vs 3.3%, P < 0.001). The overall incidence of postoperative complications including acute renal failure, MI, wound infection, and duration of hospital stay are also higher in on pump group as compared to OPCABG.Conclusion: Off pump CABG is safe and associated with good clinical outcome and can be considered alternative to conventional CABG as treatment modality for surgical coronary revascularization but this will need large scale study to establish this technique.