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    Patient Selection Criteria For Off-Pump and On-Pump Coronary Artery Bypass Grafting
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2014) Gokalp, Fatih; Ozcinar, Evren; Tiryakioglu, Osman; Kenar, Selma Tiryakioglu
    Background: This study compares safety, efficacy, and reasons of selection criteria between off-pump coronary bypass grafting (OPCAB) and conventional on-pump coronary bypass grafting (CCAB) in patients with coronary artery disease. Material and Methods: The study feeds on a retrospective, observational cohort study of data collected from 540 consecutive patients with coronary artery disease undergoing isolated CABG (coronary artery bypass grafting) (270 OPCAB , 270 CCAB) between March 2003 and January 2013. Two hundred and seventy patients who underwent surgery with on-pump method (group 1) were compared to the group of 270 patients who underwent surgery with off-pump method (group 2). Results: The mean number of anastomoses was 3.1±0.6 in group 1 and 2.1±0.7 in group 2; the difference was significant (p=0.016). The duration of mechanical ventilation support time was shorter for patients in group 2 (p=0.0001). The number of patients with three and/or four target vessel coronary artery bypasses in group 1 was substantially higher compared with the patients in group 2, while the number of patients undergoing one and/or two target vessel bypasses was substantially lower. The levels of CK-MB and troponin I were substantially lower in group 2. Group 2 patients demonstrated shorter hospital stay period than group 1 patients (p=0.0001). Conclusion: The off-pump operation technique is preferred for patients with less target vessel anastomoses, while the on-pump operation technique is preferred for the patients with diabetes mellitus, multiple coronary artery lesions, and left main coronary artery (LMCA) lesions.