Postoperative Safety Of Off-Pump Versus On-Pump Coronary Artery Bypass Grafting

ObjectiveThe aim was to compare the short-term (30days after surgery) and long-term (over6months’ follow up) postoperative safety of off-pump and on-pump coronary artery bypass grafting (CABG) for coronary heart disease (CHD) patients.MethodsRelevant randomized controlled trials (RCTs) were obtained from PubMed, Embase, Springer, Ovid and Cochrane library up to July,2013. Odds ratios (ORs) with their95%confidence intervals (CI) were used to access effect sizes.ResultsTotal7RCTs involving9128patients were included. Results suggested no significant difference in all the short-term outcomes (mortality, OR=0.90,95%CI:0.69-1.16, P=0.41; myocardial infarction, OR=0.95,95%CI:0.79-1.15, P=0.61; stroke, OR=0.78,95%CI:0.56-1.07, P=0.12; renal failure, OR=0.84,95%CI:0.60-1.18, P=0.43; revascularization:OR=1.95,95%CI:0.79-4.85, P=0.15) and some long-term outcomes (mortality, OR=1.02,95%CI:0.86-1.22, P=0.81; myocardial infarction, OR=0.86,95%CI:0.70-1.04, P=0.12; stroke, OR=0.89,95%CI:0.67-1.19, P=0.44) between off-pump and on-pump CABG. However, off-pump CABG had significantly higher revascularization rate (OR=1.45;95%CI:1.02-2.06; P=0.04) than on-pump CABG in long-term follow up.ConclusionShort-term postoperative safety was similar between off-pump with on-pump CABG. High revascularization rate was the drawback of off-pump CABG for CHD patients in long-term follow up.