Comparison Of Anesthetic Management And Early Outcome With On-pump And Off-pump Coronary Artery Bypass Grafting

Object:To compare the anesthetic management and early outcome of on-pump and off-pump CPBCABG in a prospective randomized controlled trial. METHODS: 131 consecutive unselected patients referred for elective primary CPBCABG were randomly assigned to accept either on-pump (n=45) or off-pump (n=86) CPBCABG. The anesthetic management and clinical outcomes were compared.RESULTS:The operation time in off-pump group was significantly shorter than that in on-pump group [(244±47) min VS. (312±59) min](P<0.05). The bleeding and frequency of need for blood or blood products transfusion was higher in on-pump group compared with off-pump group (P<0.05). The number of grafts performed per patient[(2.7±0.6) for off-pump CPBCABG and (2.9±0.7) for on-pump CPBCABG]were similar. There were no hospital deaths in either group. The incidence of perioperative complications in off-pump group was significantly lesser than that in on-pump group (P<0.05). Postoperative serum CK-MB levels increased above normal value in the two groups, but it was more pronounced in on-pump group (P<0.05). CONCLUSION:OPCABG with multiple arterial grafts is as safe as traditional CPBCABG. The incidence of perioperative complications and the postoperative recovery of off-pump group is more satisfactory than that of on-pump group.