Heart Vessels and Transplantation (Dec 2023)
A retrospective observational study of risk factors, angiographic patterns, short-term mortality and their correlations between on- pump and off- pump coronary artery bypass surgery
Abstract
Objective: The decision to perform on-pump or off-pump coronary bypass surgery (CABG) depends on various parameters such as myocardial contractility, thickness of the myocardium and overall surgeon preference. There are very few studies analyzing the same. Hence, the aim of the study is to investigate the distribution of different risk factors, angiographic patterns and short-term mortality in patients undergoing between on -pump CABG and off- pump CABG groups and compare short-term outcomes among different subgroups of patients with coronary artery disease. Methods: The present study is a retrospective observational study with data from August 2016 to December 2021 undertaken in government general hospital Kurnool, India. A total of 108 patients were taken of whom 36 constituted on-pump CABG group and 72 – off- pump CABG group, were present eligible as per inclusion criteria and exclusion criteria. The data considered includes the age, risk factors, echocardiographic reports, angiographic data, surgery details and post-surgery status. Results: The mean age of patients was 56.21 (10.2) years with maximum age of 85 years and minimum age of 35 years. The distribution of population by sex: male - 90 (83.3%) and female – 18 (16.7%). The smoking as a risk factor was found in 60(55.6%) patients, alcohol - 36 (33.3%) patients, diabetes -28 (25.9 %) patients, and hypertension - 19 (17.6%) patients. Some of them have more than one risk factor. The mean ejection fraction (EF) of the patients was 43 .66 (6.2%) with the highest EF noted 63% and lowest 30%. The patients with single- vessel disease were 26 (24.1%), double -vessel disease - 35 (32.4%), triple vessel disease - 47 (43.5%). Of all patients, 36 undergone on pump CABG of whom 12 patients (33.3%) died and 72 patients undergone off pump CABG, of whom 6 (8.3%) succumbed after the surgery (p<0.05). Conclusion: The on-pump group had significantly more often mortality rate than off- pump group. Increasing age group above 60 years, reduced EF, involvement of left main coronary artery, smoking and alcoholism were associated with morbidity and mortality in on-pump CABG than off-pump CABG.
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