Objective: There is no common concencus the clinical
results of coronary artery bypass grafting (CABG) surgery patients who
underwent off-pump or conventional techniques. Our aim of this study was to compare
the changes of myocardial functions, patients’ clinical results, biochemical
marker release during surgery and postoperatively in On- and Off-Pump CABG
surgery. Method: A consecutive series of 50 coronary artery disease (CAD)
patients who underwent elective CABG surgery included for this study. The
patients were divided into two groups (Group 1, N = 25 and group 2, N = 25).
Demographic data including the patients’ age, gender, body mass index (BMI),
diseased coronary artery numbers, LVEF were similar. Postoperative red package blood cell, fresh frozen
plasma, and thrombocyte requirements were high in On-Pump group (p < 0.05). But there was not any significant
difference when compared the number of unexpected surgery because of
mediastinal bleeding after operations in both groups. Preoperative and postoperative N-Terminal Pro-Brain
Natriuretic Peptide (NT-proBNP), cardiac Troponin-I (cTnI) levels during and
after surgery, and left ventricular ejection fractions (LVEF) prior to
discharge from hospital were compared. Results:
There were no statistical significancy when compared postoperative mortality
and morbidity. The operations time was low in off-pump group (p <
0.05). The NT-proBNP levels were similar in both groups (p > 0.05). However, cTnI levels were
significantly higher in the on-pump group (p = 0.0001). Postoperative LVEF decreased significantly in both groups when
compared to preoperative echocardiography examinations (p = 0.001). But the changes of postoperative LVEFs in both groups were not statistical significant (p > 0.05). Conclusion: Our study results indicated that cardiac
enzyme release was high after On-Pump CABG surgery. However, LVEF decreased in both techniques. There were some advantages of
OPCAB operations such as decrease of inflammatory responses and angina pectoris
incidence due to extracorporeal circulation; however, these techniques did not
affect postoperative mortality and morbidity. Therefore, in selected cases to
provide longer operation time, Off-Pump CABG could be used but it has no
superiority over On-Pump CABG surgery.
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