One-year outcomes after off-pump coronary artery bypass grafting in diffuse coronary atherosclerosis

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OBJECTIVE

To analyze the outcomes after off-pump and on-pump coronary artery bypass grafting (CABG) in patients with diffuse coronary artery disease (CAD).

MATERIAL AND METHODS

A retrospective study enrolled patients with diffuse CAD, who underwent CABG between 2018 and 2021. Most ones underwent on-pump surgery (n=822), others — off-pump CABG (n=97). Patients were divided into comparable groups (97 ones in each group) using propensity match scoring. We compared in-hospital and one-year outcomes. The median follow-up was 14 (12; 22) months.

RESULTS

Baseline clinical and demographic parameters were comparable in both groups. Men prevailed (79.4% and 77.3%, respectively). Mean age was 64.3±8.7 and 64.4±7.5 years, respectively. In-hospital mortality and incidence of major cardiovascular events and other complications were similar. Length of ICU-stay (48 (28; 50) vs 24 (24; 48) hours, p<0.001) and hospital-stay (11.0 (9.0; 13.0) vs 8.0 (6.5; 9.0) days, p<0.001) was greater after on-pump CABG. One-year mortality (2.2% vs 2.2%) was comparable. Myocardial infarction was not registered in both groups in a year after surgery. Recurrence of angina was more common after off-pump CABG (10.9% vs 6.7%) without significant difference.

CONCLUSION

Outcomes after off-pump CABG were not worse than after on-pump surgery. Off-pump CABG can be performed in patients with favorable coronary anatomy. Microsurgical technique and adequate surgical experience are essential.

Keywords:

coronary artery bypass grafting

cardiopulmonary bypass

diffuse coronary atherosclerosis

Authors:

Borzov E.A.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0003-4957-5182

Latypov R.S.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0002-1652-7232

Vasiliev V.P.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0002-2297-6026

Burmistrova I.V.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0003-0445-6219

Kurbanov S.K.

Chazov National Medical Research Center of Cardiology

ORCID: 0000-0001-7767-1695

Shiryaev A.A.

Chazov National Medical Research Center for Cardiology

ORCID: 0000-0002-3325-9743

Received:

30.10.2023

Accepted:

03.11.2023

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