Retrospective observational analysis of a coronary artery bypass grafting surgery patient cohort: Off-pump versus on-pump

OBJECTIVES: To determine whether surgical technique has an effect on prognosis in coronary artery bypass grafting (CABG). DESIGN: Retrospective observational. SETTING: Single center. PARTICIPANTS: All the off-pump (OPCABG) and on-pump (ONCABG) patients at Turku University Central Hospital in 2018. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: After propensity score matching, perioperative, 1-year and 3-year mortality did not differ between the groups. The ONCABG patients received more allogenic red blood cells (1.3 vs. 0.6 units, p = 0.020), autologous red blood cells (564 vs. 285 ml, p < 0.001) and crystalloids (3388 vs. 2808 ml, p < 0.001), and had higher postoperative values of troponin T (581 vs. 222, p = 0.001) and lactate (1.69 vs. 1.23, p < 0.001) than the OPCABG patients. CONCLUSIONS: The both techniques seem equally safe. However, there may be some benefits to avoiding using a heart-lung machine, such as lower infused fluid volumes. Myocardial damage may also be milder and postoperative hemodynamics more balanced in OPCABG patients, based on lower levels of troponin T and lactate.