Clinical Results of 100 Cases of Coronary Artery Bypass Grafting without Cardiopulmonary Bypass / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Coronary artery bypass grafting on the beating heart is no longer a new methods for any cardiac surgeon. We evaluated the application of the off-pump coronary artery bypass procedure relative to safety and efficiency as measured by postoperative complication and operative mortality. MATERIAL AND METHOD: We used our retrospective database to compare the patients having off-pump coronary surgery (n=100) with those having on-pump coronary surgery (n=100) between June, 1999 and August, 2002. Patients whom underwent associated valvular or aortic aneurysmal operation were excluded. RESULT: Neither groups showed any differences in the patient's risk factors and extent of coronary disease. Off-pump CABG group did not have significantly less mean operation time (295+/-73 min vs 323+/-83 min, p=ns) and mean hospital day (15.34+/-6.02 day vs 13.80+/-4.95 day, p=ns). However, off-pump CABG group had significantly shorter mean ventilation time (17.3+/-11.27 hour vs 24.98+/-16.1 hour, p<0.05). No patients were converted to on-pump CABG in off-pump CABG. Intraoperative hemodynamic instability in off-pump CABG were 6 cases, of whom 2 cases were in lateral wall approach and 4 cases in right coronary anastomosis. Postoperative mortality was 1 case in off-pump CABG and 2 cases in on-pump CABG. Intra-aortic ballon pump (IABP) was applied in 1 case with off-pump CABG and in 2 cases with on- pump CABG. No patients presented postoperative cerebral infarction & stroke in off-pump CABG but 2 patients in on-pump CABG. Postoperative arrhythmia presented in 4 cases with off-pump CABG and in 6 cases with on-pump CABG. Acute renal failure (ARF) was complicated in 3 cases with off-pump CABG and in 2 cases with on-pump CABG. CONCLUSION: This study documented the immediate safety and efficiency of the off-pump CABG procedure.