Early outcomes of On Pump versus Off Pump CABG in patients with Left Ventricular Dysfunction
DOI:
https://doi.org/10.55958/jcvd.v18i3.192Abstract
INTRODUCTION: There is little data available on the application of an on-pump technique for surgical revascularization in patients with significant left ventricular (LV) dysfunction. It is still debatable whether patients with severe left ventricular failure should have coronary artery bypass grafting (CABG) done on-pump or off-pump to restore blood flow. So, this study aims to assess the early clinical outcomes of patients undergoing surgical revascularization using either an on-pump or an off-pump approach in patients with an LVEF of ?35 %.
AIMS & OBJECTIVES: The aim of the study was to assess the early clinical outcomes of patients undergoing surgical revascularization using either an on-pump or an off-pump approach in patients with an LVEF of ?35 %.
MATERIAL & METHODS: This was a cross sectional study in which 180 patients undergoing CABG were enrolled. Nonprobability purposive sampling technique used to select the patients.
RESULTS: The average age of the individuals in Group A was 54.86 ± 8.49, whereas in Group B it was 53.94 ± 9.68. In Group A, 67.8% of the individuals were male while in Group B, 64.4% were male. The comparison of mortality, pulmonary complications, neurological complications and renal complications was found insignificant with respective insignificant p-values being as 0.560, 0.351, 0.312 and 0.155.
CONCLUSION: In this study both groups experienced comparable rates of mortality, neurologic, pulmonary, and renal complications so, it is challenging to determine whether off-pump or on-pump CABG can serve as a standard treatment for patients with significant left ventricular failure.
References
Xia L, Ji Q, Song K, Shen J, Shi Y, Ma R, Ding W, Wang C. Early clinical outcomes of on-pump beating-heart versus off-pump technique for surgical revascularization in patients with severe left ventricular dysfunction: the experience of a single center. Journal of cardiothoracic surgery. 2017 Dec;12:1-8.
Aydin A, Erkut B. On-pump beating heart coronary revascularization: Is it valid for emergency revascularization?. Annals of Saudi Medicine. 2015 Mar;35(2):133-7.
Elmahrouk AF, Hamouda TE, Kasab I, Ismail MF, Jamjoom AA. Short term outcome of conventional versus off-pump coronary artery bypass grafting for high-risk patients. Journal of the Egyptian Society of Cardio-Thoracic Surgery. 2018 Mar 1;26(1):57-63.
Wang W, Wang Y, Piao H, Li B, Wang T, Li D, Zhu Z, Xu R, Liu K. Early and medium outcomes of on-pump beating-heart versus off-pump CABG in patients with moderate left ventricular dysfunction. Brazilian journal of cardiovascular surgery. 2019 Jan;34:62-9.
Shah SM, Awan NI, Jan A, Rehman MU. Characteristics, morbidity and mortality factors associated with intra-aortic balloon pump in coronary artery bypass graft surgery patients. Pakistan Journal of Medical Sciences. 2020 Sep;36(6):1318.
Schampaert S, van Nunen LX, Pijls NH, Rutten MC, van Tuijl S, van de Vosse FN, van ‘t Veer M. Intra?aortic balloon pump support in the isolated beating porcine heart in nonischemic and ischemic pump failure. Artificial Organs. 2015 Nov;39(11):931-8.
Jiang Y, Xu L, Liu Y, Deng B, Dong N, Chen S. Beating-heart on-pump coronary artery bypass grafting vs. off-pump coronary artery bypass grafting: a systematic review and meta-analysis. Journal of Thoracic Disease. 2021 Jul;13(7):4185.
Kim HJ, Oh YN, Ju MH, Kim JB, Jung SH, Chung CH, Lee JW, Choo SJ. On-pump beating heart versus conventional coronary artery bypass grafting: comparative study on early and long-term clinical outcomes. Journal of Thoracic Disease. 2018 May;10(5):2656.
Phothikun A, Nawarawong W, Tantraworasin A, Phinyo P, Tepsuwan T. The outcomes of three different techniques of coronary artery bypass grafting: On-pump arrested heart, on-pump beating heart, and off-pump. PLoS One. 2023 May 31;18(5):e0286510.
Shroyer AL, Grover FL, Hattler B, Collins JF, McDonald GO, Kozora E, Lucke JC, Baltz JH, Novitzky D. On-pump versus off-pump coronary-artery bypass surgery. New England Journal of Medicine. 2009 Nov 5;361(19):1827-37.
Hussain G, Azam H, Baig MA, Ahmad N. Early outcomes of on-pump versus off-pump Coronary Artery Bypass Grafting. Pakistan Journal of Medical Sciences. 2016 Jul;32(4):917.