On-Pump Beating Myocardial Revascularization in Patients with Acute Coronary Syndrome

Abstract

Introduction: The on-pump beating heart technique for myocardial revascularization with a normothermic Cardiopulmonary bypass (CPB) represents a combination of standard on-pump and off-pump bypass techniques. The purpose of our study was to evaluate the outcome of patients with acute coronary syndrome undergoing on-pump beating coronary artery bypass grafting (CABG).Methods: Between February 2020 and February 2021, 125 consecutive patients with acute coronary syndrome requiring coronary revascularization and not candidate for primary angioplasty or thrombolytic therapy, underwent on-pump beating myocardial revascularization. In this cohort study the primary inclusion criteria were the persistence of coronary artery disease (CAD) suitable for CABG and acute coronary syndrome. Our outcome variables included all-cause mortality, low cardiac output state, arrhythmia, postoperative myocardial infarction (MI), respiratory failure, stroke, ICU and total hospital stay.Results: Mean age of patients was 59.11±9.81 years (range 33–84 years) and 68% of patients were male. Preoperative mean left ventricular ejection fraction was 43.61 ± 9.61 % (range 10-60 %) which improved to 46.71±8.41% postoperatively (p=0.010). The average number of graft per patient was 2.91±0.71 and complete revascularization was performed in 119 patients (95.2%). Mean ICU stay of patients was 2.11±1.41 (range 1–12) and mean hospital stay of patients was 6.11 ± 3.71 (range 5–15). Three patients (2.4%) died during recovery in the ICU due to acute cardiac failure.Conclusion: On-pump beating CABG (OPBCABG) is an effective strategy with improved hospital outcome and can be a good alternative to conventional CABG and off-pump cardiac bypass surgery in acute coronary syndrome (ACS).

Keywords

• coronary artery bypass grafting
• myocardial revascularization
• acute coronary syndrome