Abstract:

Objective Coronary artery bypass grafting (CABG) is generally considered the principal therapy for patients with coronary heart disease, which consisted of on-pump CABG (ONCABG) or off-pump CABG (OPCABG). To compare the earlier clinical results between heart-beating on-pump and off-pump CABG in 1 650 male patients.Methods The perioperative data of 1 650 male patients who underwent CABG were investigated based on the perioperative CABG database from 2007 to 2009. The earlier clinical results between heart-beating on-pump and off-pump CABG were compared. The risk factors of postoperative in-hospital mortality and CRRT were also identified by multiple logistic regressions.Results The duration of CABG and total operation of OPCABG group were less than those of ONCABG group(P<0.01).There were more cases of grafts >3 (20.9% vs 13.3%)(P<0.01)and less cases of CRRT(1.33% vs 3.98%)and IABP(3.23% vs 6.63%)in OPCABG group. There was no significant difference in in-hospital mortality between two groups. Multivariate analysis demonstrated that preoperative ejection fraction (EF) less than 40% (P=0.000,OR=8.321), more than 70 years (P=0.003,OR=4.870) and postoperative CRRT (P=0.000,OR=45.500) were the independent risk factors of postoperative in-hospital mortality; preoperative hypertension (P=0.049,OR=2.665), preoperative renal dysfunction(P=0.045,OR=3.598) were the independent risk factors, while the usage rate of continuous renal replacement therapy (CRRT) was reduced by two thirds in male patients undergoing off-pump coronary artery bypass grafting. Conclusion OPCABG was a better alternative to heart-beating ONCABG for patients with age>70 years and/or preoperative poor renal function and/or cardiac dysfunction.

Key words: coronary artery bypass grafting, continuous renal replacement treatment, intra-aortic ballon pump, mortality, risk factors