Short-term and Long-term Postoperative Safety of Off-Pump versus On-Pump Coronary Artery Bypass Grafting for Coronary Heart Disease: A Meta-analysis for Randomized Controlled Trials

Abstract

Short-term postoperative safety was similar between off-pump and on-pump CABG. A high revascularization rate was the drawback of off-pump CABG for CHD patients in long-term follow-up.

Predictors of Quality of Life Improvement after 2 Years of Coronary Artery Bypass Surgery

“…It can be done with the use of extracorporeal circulation or without ("on-pump" or "off-pump"), with small differences in the efficiency of these two methods. 7,8) Our research included patients who were operated by "on-pump" method, which is today represented in the world in over 80% of procedures, 9) and which still in certain categories of patients shows better results. 10) We have already reported on QOL improvement that patients have 6 months after CABG.…”

On vs. off pump coronary artery bypass grafting: the next chapter

“…Some caution might therefore be advised in the interpretation of the results. Nevertheless, the synthesised results showed that there was no difference in the incidence of mortality, myocardial infarction and stroke between the two groups; however, there was a significantly higher rate of revascularisation in the off pump group (12). It is noteworthy that the single 6 months follow up and the two 1-year follow ups discussed in this metaanalysis were from three of the large RCTs mentioned above (CORONARY, DOORS and GOPCABE) (12).…”

“…Nevertheless, the synthesised results showed that there was no difference in the incidence of mortality, myocardial infarction and stroke between the two groups; however, there was a significantly higher rate of revascularisation in the off pump group (12). It is noteworthy that the single 6 months follow up and the two 1-year follow ups discussed in this metaanalysis were from three of the large RCTs mentioned above (CORONARY, DOORS and GOPCABE) (12). It should also be noted that Luo et al missed at least one study, namely that of Angelini et al who pooled the follow up (1-3 years) results of two of their RCTs (13).…”

“…Unfortunately, relatively few authors have published follow ups to their studies. For example, Luo et al in their 2015 meta-analysis of RCTs with >6 months follow up only synthesised the results of four studies for mortality and only three studies for incidence of myocardial infarction, stroke and revascularisation (12). Some caution might therefore be advised in the interpretation of the results.…”

Is there a long-term survival benefit with on pump coronary artery bypass grafting?

“…It is worth mentioning two further meta-analyses in this section, because they attempted to investigate longer-term outcomes, although longerterm in these cases means either 1-year of followup or anything over 6 months. One of these studies used inclusion criteria, which excluded participants with a mean age <60 years (13). As a consequence, only 4 so-called long term studies were included [GOPCABE (1-year) (12); DOORS (6-months) (10); CORONARY (1-year) (14) and Møller (3-year) (15)] and significant RCTs including Angelini et al (4) were missed.…”