Comparative Studies Of On-pump And Off-pump Coronary Artery Bypass Grafting

Objective To campare the effect of on-pump coronary artery bypass grafting(CCABG) with off-pump coronary artery bypass grafting(OPCABG), discuss the feasibility and superiority of OPCABG, summarize the clinical experience of CABG. Methods From November 1997 to November 2010, 292 patients with coronary heart disease(CHD) underwent coronary artery bypass grafting(CABG). Depending on the surgical methods, they were divided into two groups, 152 cases in CCABG group, 140 in OPCABG group. The clinical preoperative data include sex, age, weight, cardiac function(NYHA) and complications. The clinical data after surgery included the sum of grafts, time of ventilation, time in the ICU, the chest drainage amount, the total blood transfusion, hospital day, atrial fibrillation, pleural effusion, wound infection, mortality during surgery, etc. Results There were no significant difference in preoperative clinical data. The difference during surgery include these following aspects, there were significant difference in the time of ventilation, time in the ICU, and hospital day(P<0.05). The chest drainage amount and total blood transfusion 24 hours after surgery of CCABG group were more than these of OPCABG group(P<0.05). The incidence of postoperative complications of CCABG group and OPCABG were 46.1%, 25.0% separatively. The complications included atrial fibrillation, pleural effusion, wound infection in OPCABG group were less than these in CCABG group(P>0.05). The incidence of pleural effusion was higher of CCABG group(P<0.05). The operative mortality of CCABG group was more than that of OPCABG group(P>0.05). Conclusions By comparing the clinical data of the two groups, patients with CHD underwent OPCABG can reduce the incidence of postoperative complications. The early clinical effects of OPCABG were better than CCABG. OPCABG can achieve complete myocardial revascularization as CCABG. The comparison of the long-term patency of grafts and effects of CCABG with OPCABG remain to be further studied.