Comparing the outcome of on-pump versus off-pump coronary artery bypass grafting in patients with preoperative atrial fibrillation

Abstract

PAF is associated with a higher incidence of postoperative complications. Our results have demonstrated that patients in PAF undergoing ONCAB are more susceptible to the postoperative complications compared to those in SR. However, there were no differences in mid- and long-term outcomes.

On-Pump vs Off-Pump coronary artery bypass surgery in atrial fibrillation. Analysis from the polish national registry of cardiac surgery procedures (KROK)

“…First and most important finding of the current report is that as compared to Off-Pump, On-Pump CABG was associated with higher early (24 hours) and 30-day all-cause mortality after PS matching (HR [95%CIs]: 8.00 [1.01-63.78] P = 0.049; and 3.58 [1.34-9.61] P = 0.001 respectively). The finding is in line with another report from Attaran [12] that while not powered for hard clinical endpoints, demonstrated that patients undergoing on-pump CABG, presence of underlying AF was associated with poorer postoperative outcomes; inotropic support rates as well as need for IABP support remained significantly higher in AF, even after adjusting for preoperative characteristics. Authors suggested more apparent and negative effect of CPB in patients with AF at short-term; even despite maintaining acceptable perfusion pressures during CPB.…”

“…No single randomized study has ever before addressed the safety of On-Pump CABG vs Off-Pump CABG in this particular setting of AF and data from small observational samples remains inconclusive [12,13]. Driven by this fact, we designed an analysis, in which we report long-term survival results after On-Pump and Off-Pump CABG in AF from the Polish National Registry of Cardiac Surgery Procedures (Krajowy Rejestr Operacji Kardiochirurgicznych [KROK]).…”

Coronary vasculature and postoperative atrial fibrillation: a risk factor analysis

“…In another analysis by the same authors, postoperative AF was found to be associated with increased postoperative complications in on-pump operations only. [5] In this study, we analyzed the outcome results of consecutive CABG operations to determine the relationship between coronary vasculature, the nature and extent of coronary artery disease (CAD), and postoperative occurrence of AF. Postoperative mortality and morbidity were also compared.…”

Preoperative atrial fibrillation portends poor outcomes after coronary bypass graft surgery: A systematic review and meta-analysis

“…After the full text of the remaining 81 articles was screened, 12 studies met the inclusion criteria. [8][9][10][11][12][17][18][19][20][21][22][23] All included studies were retrospective observational reports (Table 1). These included data on a total of 389,998 patients who underwent CABG; 370,292 patients did not have preAF and 19,706 had preAF.…”

“…Some cohort studies have demonstrated that preAF may be an independent risk factor for poorer perioperative outcomes and reduced long-term survival. [8][9][10][11][12] However, there has only been a limited evaluation of preAF in the context of CABG surgery, and the EuroSCORE has not recognized preAF as a risk modifier. Moreover, the impact of preAF on clinical outcomes according to revascularization strategy (on-pump or off-pump CABG) remains largely unexplored.The primary aim of this of this meta-analysis was to evaluate the impact of preAF on short-and long-term outcomes after CABG surgery.…”