Coronary artery bypass grafting with cardiopulmonary bypass versus off-pump cardiopulmonary bypass grafting

Does eliminating the pump reduce morbidity and cost?

David A. Bull, Leigh A Neumayer, James C. Stringham, Patricia Meldrum, David G. Affleck, Shreekanth V. Karwande

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Background. Cardiopulmonary bypass (CPB) may contribute to the complications and cost of coronary artery bypass grafting (CABG). Off-pump CABG (OPCAB) allows coronary revascularization without CPB. We hypothesized that OPCAB provides satisfactory graft patency while reducing complications and cost compared with CABG with CPB. Methods. We prospectively followed 80 patients undergoing CABG: 40 patients undergoing OPCAB and 40 patients undergoing CABG with CPB. OPCAB patients underwent angiography within 48 hours of surgery to determine early graft patency. Incidence of complications, length of stay, and costs were recorded for each patient. The influence of the number of vessels bypassed was analyzed. Results. OPCAB patients (n = 40) underwent grafting of 2.7 ± 0.7 vessels per patient compared with 3.6 ± 0.8 vessels per patient in the CABG with CPB group (n = 40) (p < 0.0001). Angiography demonstrated 105 of 108 (97%) of grafts were patent in the OPCAB group. Incidence of complications, length of stay, and costs did not differ between the OPCAB and CABG with CPB groups. Number of vessels grafted showed a positive correlation to total costs in both groups. Conclusions. While OPCAB provided satisfactory early graft patency, there was no significant difference between OPCAB and CABG with CPB with regard to cost, length of stay, or incidence of complications. In this study, eliminating CPB did not reduce morbidity or cost after CABG.

Original languageEnglish (US)
Pages (from-to)170-175
Number of pages6
JournalAnnals of Thoracic Surgery
Volume71
Issue number1
DOIs
StatePublished - 2001
Externally publishedYes

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Cardiopulmonary Bypass
Coronary Artery Bypass
Morbidity
Costs and Cost Analysis
Off-Pump Coronary Artery Bypass
Transplants
Length of Stay
Incidence
Angiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Coronary artery bypass grafting with cardiopulmonary bypass versus off-pump cardiopulmonary bypass grafting : Does eliminating the pump reduce morbidity and cost? / Bull, David A.; Neumayer, Leigh A; Stringham, James C.; Meldrum, Patricia; Affleck, David G.; Karwande, Shreekanth V.

In: Annals of Thoracic Surgery, Vol. 71, No. 1, 2001, p. 170-175.

Research output: Contribution to journalArticle

Bull, David A. ; Neumayer, Leigh A ; Stringham, James C. ; Meldrum, Patricia ; Affleck, David G. ; Karwande, Shreekanth V. / Coronary artery bypass grafting with cardiopulmonary bypass versus off-pump cardiopulmonary bypass grafting : Does eliminating the pump reduce morbidity and cost?. In: Annals of Thoracic Surgery. 2001 ; Vol. 71, No. 1. pp. 170-175.
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abstract = "Background. Cardiopulmonary bypass (CPB) may contribute to the complications and cost of coronary artery bypass grafting (CABG). Off-pump CABG (OPCAB) allows coronary revascularization without CPB. We hypothesized that OPCAB provides satisfactory graft patency while reducing complications and cost compared with CABG with CPB. Methods. We prospectively followed 80 patients undergoing CABG: 40 patients undergoing OPCAB and 40 patients undergoing CABG with CPB. OPCAB patients underwent angiography within 48 hours of surgery to determine early graft patency. Incidence of complications, length of stay, and costs were recorded for each patient. The influence of the number of vessels bypassed was analyzed. Results. OPCAB patients (n = 40) underwent grafting of 2.7 ± 0.7 vessels per patient compared with 3.6 ± 0.8 vessels per patient in the CABG with CPB group (n = 40) (p < 0.0001). Angiography demonstrated 105 of 108 (97{\%}) of grafts were patent in the OPCAB group. Incidence of complications, length of stay, and costs did not differ between the OPCAB and CABG with CPB groups. Number of vessels grafted showed a positive correlation to total costs in both groups. Conclusions. While OPCAB provided satisfactory early graft patency, there was no significant difference between OPCAB and CABG with CPB with regard to cost, length of stay, or incidence of complications. In this study, eliminating CPB did not reduce morbidity or cost after CABG.",
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