Coronary artery bypass without cardiopulmonary bypass

Ann Thorac Surg. 1992 Dec;54(6):1085-91; discussion 1091-2. doi: 10.1016/0003-4975(92)90074-e.

Abstract

The purpose of this article is twofold: to describe our technique for performing coronary artery bypass grafting without cardiopulmonary bypass (off pump) and to demonstrate that this operation is safe, in terms of mortality and certain indices of morbidity. Very little has been published in regard to off-bypass operations. From 1985 through 1990, 220 patients underwent operation off bypass; 220 on-pump controls were retrospectively matched for number of grafts, left ventricular function, and date of operation. Groups were compared in terms of mortality and ten indicators of morbidity. The same analysis was performed for ten subgroups. We found no statistically significant difference between groups in mortality (off pump, 1.4% [3/220]; on pump, 2.4% [5/220]), which held across all subgroups. Patients undergoing operation off pump required blood far less often (not transfused: off pump, 72.7% [160/220]; on pump, 54.6% [116/220]; p = 0.005 by Fisher's exact test), and the low output state occurred statistically less frequently off pump (off pump, 5.5% [12/220]; on-pump, 12.7% [28/220]; p = 0.01 by Fisher's exact test). Further research should be directed to which subgroups can be operated on to advantage off pump and which, if any, groups of patients should be confined to on-bypass operations.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Transfusion / statistics & numerical data
  • Cardiac Output, Low / epidemiology
  • Cardiac Output, Low / etiology
  • Cardiac Output, Low / therapy
  • Cardiopulmonary Bypass / mortality
  • Cardiopulmonary Bypass / standards*
  • Comorbidity
  • Coronary Artery Bypass / methods
  • Coronary Artery Bypass / mortality
  • Coronary Artery Bypass / standards*
  • District of Columbia / epidemiology
  • Female
  • Hospital Mortality
  • Humans
  • Incidence
  • Intensive Care Units / statistics & numerical data
  • Intra-Aortic Balloon Pumping / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Matched-Pair Analysis
  • Mediastinitis / epidemiology
  • Mediastinitis / etiology
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Treatment Outcome
  • Ventricular Function, Left