PLoS ONE (Jan 2020)

On-Pump vs Off-Pump coronary artery bypass surgery in atrial fibrillation. Analysis from the polish national registry of cardiac surgery procedures (KROK).

  • Mariusz Kowalewski,
  • Marek Jasiński,
  • Jakub Staromłyński,
  • Marian Zembala,
  • Kazimierz Widenka,
  • Mirosław Brykczyński,
  • Jacek Skiba,
  • Michał Zembala,
  • Krzysztof Bartuś,
  • Tomasz Hirnle,
  • Inga Dziembowska,
  • Piotr Knapik,
  • Zdzisław Tobota,
  • Bohdan Maruszewski,
  • Piotr Suwalski,
  • KROK Investigators

DOI
https://doi.org/10.1371/journal.pone.0231950
Journal volume & issue
Vol. 15, no. 4
p. e0231950

Abstract

Read online

BackgroundNo single randomized study has ever before addressed the safety of On-Pump coronary artery bypass grafting (CABG) vs Off-Pump CABG in the setting of atrial fibrillation (AF) and data from small observational samples remain inconclusive.Methods and findingsProcedural data from KROK (Polish National Registry of Cardiac Surgery Procedures) were retrospectively collected. Of initial 188,972 patients undergoing CABG, 7,913 presented with baseline AF (76.0% men, mean age 69.1±8.2) and underwent CABG without concomitant valve surgery between 2006-2019 in 37 reference centers across Poland. Mean follow-up was 4.7±3.5 years (median 4.3 IQR 1.7-7.4). Cox proportional hazards models were used for computations. Of included patients, 3,681 underwent On-Pump- (46.52%) as compared to 4,232 (53.48%) who underwent Off-Pump CABG. Patients in the latter group less frequently were candidates for complete revascularization (PConclusionsOff-Pump CABG offered 30-day survival benefit to patients undergoing CABG surgery and presenting with underlying AF. On-Pump CABG was associated with significantly improved survival at long term.