Retrospective observational analysis of a coronary artery bypass grafting surgery patient cohort: Off-pump versus on-pump

Matias Rantanen; Rizgar Yousif; Minna Kallioinen; Ville-Veikko Hynninen; Marko Peltoniemi; Oki Söderholm; Tuukka Saarikoski; Vesa Anttila; Jenni Aittokallio

doi:10.1016/j.amsu.2022.104812

Retrospective observational analysis of a coronary artery bypass grafting surgery patient cohort: Off-pump versus on-pump

Ann Med Surg (Lond). 2022 Nov 9:84:104812. doi: 10.1016/j.amsu.2022.104812. eCollection 2022 Dec.

Authors

Matias Rantanen^{1

2}, Rizgar Yousif², Minna Kallioinen^{1

2}, Ville-Veikko Hynninen^{1

2}, Marko Peltoniemi^{1

2}, Oki Söderholm^{1

2}, Tuukka Saarikoski^{1

2}, Vesa Anttila³, Jenni Aittokallio^{1

2}

Affiliations

¹ Division of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland.
² Department of Anesthesiology and Intensive Care, University of Turku, Turku, Finland.
³ Heart Center, Turku University Hospital, Turku, Finland.

Abstract

Objectives: To determine whether surgical technique has an effect on prognosis in coronary artery bypass grafting (CABG).

Design: Retrospective observational.

Setting: Single center.

Participants: All the off-pump (OPCABG) and on-pump (ONCABG) patients at Turku University Central Hospital in 2018.

Interventions: None.

Measurements and main results: After propensity score matching, perioperative, 1-year and 3-year mortality did not differ between the groups. The ONCABG patients received more allogenic red blood cells (1.3 vs. 0.6 units, p = 0.020), autologous red blood cells (564 vs. 285 ml, p < 0.001) and crystalloids (3388 vs. 2808 ml, p < 0.001), and had higher postoperative values of troponin T (581 vs. 222, p = 0.001) and lactate (1.69 vs. 1.23, p < 0.001) than the OPCABG patients.

Conclusions: The both techniques seem equally safe. However, there may be some benefits to avoiding using a heart-lung machine, such as lower infused fluid volumes. Myocardial damage may also be milder and postoperative hemodynamics more balanced in OPCABG patients, based on lower levels of troponin T and lactate.

Keywords: Coronary artery bypass grafting; Off-pump; On-pump.