Comparison of Long-term Outcomes of On-pump and Off-pump Techniques in Isolated Coronary Artery Bypass Surgery: A Cohort Study İzole Koroner Arter Bypass Cerrahisinde Pompalı ve Pompasız Tekniklerin Uzun Dönem Sonuçlarının Karşılaştırılması: Bir Kohort Çalışması
Medical Journal of Bakirkoy, cilt.21, sa.3, ss.296-304, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 21 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/bmj.galenos.2025.2025.4-15
- Dergi Adı: Medical Journal of Bakirkoy
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.296-304
- Anahtar Kelimeler: Coronary artery bypass grafting, on-pump CABG, off-pump CABG, long-term outcomes, postoperative complications
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This study aims to analyze and compare the short- and long-term clinical outcomes of on-pump versus off-pump coronary artery bypass grafting (CABG) techniques in patients undergoing isolated CABG. Methods: This study was designed as a retrospective, single-institution observational analysis, including 285 patients who underwent isolated CABG between 2010 and 2023. The participants were classified into two cohorts: on-pump (n=191) and off-pump (n=94). A comprehensive evaluation of perioperative and postoperative parameters was conducted, encompassing inflammatory markers, mechanical ventilation duration, hospital and intensive care unit (ICU) stay, and long-term outcomes such as mortality, myocardial infarction (MI), and revascularization rates. Results: The on-pump group exhibited a significantly higher postoperative inflammatory response, with elevated white blood cell count (7.7±2.5 vs. 6.1±1.3 x103/µL, p<0.001) and C-reactive protein levels (11.6±13.2 vs. 7.1±1.5 mg/L, p<0.001). The postoperative drainage volume was significantly higher in the on-pump group (565.2±146.6 vs. 263.8±46.2 mL, p<0.001), as were, mechanical ventilation duration (5.2±1.0 vs. 3.5±0.7 hours, p<0.001), ICU stay (2.6±1.3 vs. 2.1±0.3 days, p<0.001), and hospital length of stay (6.7±1.8 vs. 5.3±0.7 days, p<0.001). The incidence of postoperative atrial fibrillation was significantly higher in the on-pump group (8.4% vs. 2.1%, p=0.041), whereas the prevalence of peripheral artery disease (37.7% vs. 52.1%, p=0.020) and hypercholesterolemia (34.0% vs. 48.9%, p=0.015) was higher in the off-pump group. No significant differences were found in long-term mortality, MI, or revascularization rates between the groups (p>0.05). Conclusion: While off-pump CABG was associated with lower postoperative inflammation, shorter ICU and hospital stays, and fewer early complications, both techniques demonstrated comparable long-term clinical outcomes.