On-pump beating heart versus off-pump myocardial revascularization—a propensity-matched comparison

Rao, Yashaskar Manjunatha; Potdar, Shreyas; Das, Debasis; Saha, Atanu; Kapoor, Lalit; Das, Mrinalendu; Narayan, Pradeep

doi:10.1007/s12055-021-01209-x

Cited by 4 publications

(6 citation statements)

References 33 publications

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“…In all of these compared articles, beating heart cases were shown to be superior to conventional bypass in accordance with our series. In some series, more impressive results were obtained compared to our series because of the population of the region, angiography and number of cases, but the number of parameters compared in our series is higher than in many other studies [25][26][27]. In some of the presented patient series, only hematological and biochemical evaluation was compared, and in some others only postoperative complications were compared [26,28].…”

Section: Discussionmentioning

confidence: 47%

“…Many articles comparing on-pump and off-pump beating heart have been published over the years [2,[25][26][27][28][29]. In some of these articles, patients with beating heart using a heart-lung machine (as in our article) were presented, while in others, beating heart cases without the use of a pump were presented and compared with the conventional bypass procedure.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of On-Pump Beating Heart Surgery Versus Conventional Bypass Surgery in Patients with Acute Myocardial Infarction Requiring Urgent Revascularization

Kilic,

Jalalzai,

Sonmez

et al. 2024

HSF

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Background: The objective of our study was to provide the initial outcomes of the traditional coronary artery surgery approach and the on-pump beating heart surgery in terms of survival and morbidity in patients who needed emergency surgery for acute myocardial infarction. Methods: A single-center retrospective study was performed from November 2013 to September 2023 on a total of 212 patients requiring emergency coronary artery surgery. Group I patients (n = 108) received traditional coronary artery bypass grafting with cross-clamping, while Group II patients (n = 104) underwent on-pump coronary surgery on the beating heart. Results: There were no disparities observed in the preoperative left ventricular function, percutaneous coronary intervention, intra-aortic balloon usage, or clinical-hemodynamic characteristics. Group I patients had significantly higher rates of postoperative mortality and low cardiac output syndrome, as well as a greater utilization of intra-aortic balloons and a higher requirement for extracorporeal membrane oxygenation (p < 0.001). Conclusions: Ultimately, the on-pump beating heart approach could serve as a viable alternative to enhance the preservation of cardiac function and decrease postoperative complications and mortality rates in patients with acute myocardial infarction who require emergency surgery.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Comparison of On-Pump Beating Heart Surgery Versus Conventional Bypass Surgery in Patients with Acute Myocardial Infarction Requiring Urgent Revascularization

Kilic,

Jalalzai,

Sonmez

et al. 2024

HSF

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“…It avoids cardioplegic arrest and aortic cross-clamping and provides adequate end-organ perfusion with reduced inotrope requirement. In high-risk patients, the OPBHC procedure provides an efficient way to perform surgical revascularization [10][11][12][13][14][16][17][18][20][21][22][24][25][26][27][28][29][30]. This evidence suggests that OPBHC may be the treatment of choice for patients who have experienced a cardiogenic shock after acute MI.…”

Section: Discussionmentioning

confidence: 99%

“…In high-risk patients, the OPBHC procedure provides an efficient way to perform surgical revascularization [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

On‐pump beating‐heart coronary artery bypass grafting: Single Center Experience and Literature Review

Triantafillou¹

2023

GSC Adv. Res. Rev.

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Purpose: In this retrospective, observational, non-randomized study, we present the results of our department in on‐pump beating‐heart coronary artery bypass grafting and we review the relevant medical literature. Methods: All data related to patients who underwent on‐pump beating‐heart coronary artery bypass grafting at our center for three consecutive years were collected. These patients were classified into two groups: isolated bypass grafts or combined with aortic valve replacement. All data related to preoperative characteristics, procedural characteristics, and clinical outcomes are presented separately for the two groups. Results: During the study period, 175 patients underwent on‐pump beating‐heart bypass grafting alone and 32 combined with aortic valve replacement. Despite higher than average Euroscore in both groups, mortality, and morbidity were satisfactory while the rate of complete revascularization was higher than previously reported for classic off-pump surgery. Conclusion: On‐pump beating heart coronary artery bypass grafting offers an excellent alternative in the surgical treatment of coronary artery disease. Patient selection is very important, and in the hands of skilled surgeons, it may prevent intraoperative complications and offer the appropriate revascularization, especially for high-risk patients.

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“…Compared with ONBEAT, C-CABG was associated with similar 4 , 14 or inferior outcomes 9 . Few studies have investigated the results of OPCAB and ONBEAT, and the limited data have demonstrated comparable outcomes between the two procedures in patients with left ventricular dysfunction 15 , 16 or worse clinical outcomes in the ONBEAT population 17 .…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy on outcomes of C-CABG, OPCAB, and ONBEAT in coronary heart disease: a systematic review and network meta-analysis of randomized controlled trials

Zhu,

Li,

Zhang

et al. 2023

International Journal of Surgery

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Importance: Coronary artery bypass grafting (CABG) remains the gold standard for the treatment of multivessel and left main coronary heart disease. However, the current evidence about the optimal surgical revascularization strategy is inconsistent and is not sufficient to allow for definite conclusions. Thus, this topic needs to be extensively discussed. Objective: The aim of this present study was to compare the clinical outcomes of off-pump CABG (OPCAB), conventional on-pump CABG (C-CABG) and on-pump beating heart (ONBEAT) CABG via an updated systematic review and network meta-analysis of randomized controlled trials (RCTs). Data Sources: PubMed, Web of Science and the Cochrane Central Registry were searched for relevant RCTs that were published in English before December 1, 2021. Study Selection Published trials that included patients who received OPCAB, C-CABG and ONBEAT CABG were selected. Data Extraction and Synthesis: Two authors independently screened the search results, assessed the full texts to identify eligible studies and the risk of bias of the included studies, and extracted data. All processes followed the Preferred Reporting Items for Systematic Review and Meta-analysis of Individual Participant Data. Main Outcomes and Measures: The primary outcome was postoperative mortality in patients who underwent C-CABG, OPCAB or ONBEAT CABG. The secondary outcomes were postoperative myocardial infarction, stroke, and renal impairment in the three groups. The time point for analysis of outcomes was all time periods during the postoperative follow-up. Results: A total of 39385 patients (83,496.2 person-years) in 65 studies who fulfilled the prespecified criteria were included. In the network meta-analysis, OPCAB was associated with an increase of 12% in the risk of all-cause mortality when compared with C-CABG (OR: 1.12; 95% CI: 1.04 to 1.21), a reduction of 49% in the risk of myocardial infarction when compared with ONBEAT (OR: 0.51; 95% CI: 0.26 to 0.99), a reduction of 16% in the risk of stroke when compared with C-CABG (OR: 0.84; 95% CI: 0.72 to 0.99) and a similar risk of renal impairment when compared with C-CABG and ONBEAT. Conclusions and Relevance: OPCAB was associated with higher all-cause mortality but lower postoperative stroke compared with C-CABG. OPCAB was associated with lower postoperative myocardial infarction than that of ONBEAT. Early mortality was comparable among OPCAB, ONBEAT and C-CABG.

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On-pump beating heart versus off-pump myocardial revascularization—a propensity-matched comparison

Cited by 4 publications

References 33 publications

Comparison of On-Pump Beating Heart Surgery Versus Conventional Bypass Surgery in Patients with Acute Myocardial Infarction Requiring Urgent Revascularization

Comparison of On-Pump Beating Heart Surgery Versus Conventional Bypass Surgery in Patients with Acute Myocardial Infarction Requiring Urgent Revascularization

On‐pump beating‐heart coronary artery bypass grafting: Single Center Experience and Literature Review

Comparative efficacy on outcomes of C-CABG, OPCAB, and ONBEAT in coronary heart disease: a systematic review and network meta-analysis of randomized controlled trials

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