A comparison of early clinical outcomes of off-pump and on-pump coronary artery bypass grafting surgery in elderly patients

Acta Chir Belg. 2018 Apr;118(2):99-104. doi: 10.1080/00015458.2017.1383087. Epub 2017 Sep 25.

Abstract

Background: The reply of question of "which coronary artery bypass grafting (CABG) technique is superior in elderly patients, off-pump or on-pump CABG surgery?" is controversial. We aimed to compare the early clinical outcomes in elderly patients undergoing off-pump and on-pump CABG.

Methods: From January 2009 to January 2015, 344 elderly patients (aged 70 or older) underwent off-pump (n = 137) or on-pump (n = 207) CABG. Patients' medical records were retrospectively reviewed, and their baseline preoperative characteristics, operative data and postoperative outcomes were analyzed, thereby a comparison of early outcomes between off-pump and on-pump patients was performed.

Results: Mean age of patients was 74.4 ± 3.8 years. Both groups were statistically similar in terms of baseline preoperative characteristics. Number of distal bypass was significantly lower in off-pump group than in on-pump group. Postoperative length of intensive care unit and hospital stay were similar between two groups. Amounts of transfused blood products were significantly lower in off-pump CABG group. There were no significant differences in terms of postoperative complications and mortality between two groups.

Conclusions: Our results did not reveal a significant benefit of either surgical technique with respect to early-term clinical outcomes in elderly CABG patients. Further investigations are needed to determine whether off-pump CABG is superior than on-pump CABG in elderly patients.

Keywords: Coronary artery bypass grafting surgery; elderly; off-pump versus on-pump.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Coronary Artery Bypass / methods*
  • Coronary Artery Bypass, Off-Pump
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / surgery*
  • Female
  • Follow-Up Studies
  • Geriatric Assessment*
  • Hospital Mortality / trends
  • Humans
  • Incidence
  • Length of Stay / trends
  • Male
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Survival Rate / trends
  • Turkey / epidemiology