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Fast-Track/Off Pump/Prediction/Outcome

Benefits of off-pump coronary artery bypass grafting (OPCABG): 041

Hofer, C. K.; Tavakoli, R.1; Maloigne, M.; Turina, M.1; Zollinger, A.; Genoni, M.1

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European Journal of Anaesthesiology: June 2004 - Volume 21 - Issue - p 21-22

Introduction: To avoid harmful effects of cardiopulmonary bypass (CPB) offpump coronary artery bypass grafting (OPCABG) is becoming increasingly important. However, effects on outcome improvement using this technique are controversial [1;2]. The aim of this observational data base analysis was to determine the short-term outcome in patients undergoing CABG using CPB or OPCABG.

Method: 697 patients undergoing CABG procedures were available for statistical analysis from 1/2001 to 12/2001. In 269 patients (38%) cardiopulmonary bypass and aortic cross-clamping (ACC) (group A), in 116 patients (17%) cardiopulmonary bypass without ACC (group B) and in 312 patients (45%) the off-pump technique (group C) was used. In 95% of patients multiple grafting (≥2 grafts) was performed. EuroSCORE, 30-day mortality, ischaemia 24 h after the intervention, transfusion requirements, duration of respiratory support and hospital stay were compared using Kruskal-Wallis and Χ2-test. P < 0.05 was considered statistically significant.

Results: EuroSCORE was comparable for the 3 groups (A = 4.2 ± 0.9, B = 4.7 ± 0.9, C = 4.6 ± 1.0).

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Discussion: In this series of patients undergoing CABG procedures a significant reduction of transfusion requirements, shortening of respiratory support duration as well as shorter hospital stay were found in patients using the off-pump approach.

References:

1 Nuttall GA, Erchul DT, Haight TJ, et al. A comparison of bleeding and transfusion in patients who undergo coronary artery bypass grafting via sternotomy with and without cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2003; 17: 447-451.
2 Reston JT, Tregear SJ, Turkelson CM. Meta-analysis of short-term and mid-term outcomes following off-pump coronary artery bypass grafting. Ann Thorac Surg 2003; 76: 1510-1515.
© 2004 European Society of Anaesthesiology