Junaid F Khan, Zafar Tufail, Sharjeel Abbas, Aamir Mansoor, Tipu Khan, Abdul Waheed, Jawad Skhan.
Comparative Study of Graft Patency in Off-Pump Vs On-Pump Coronary Artery Bypass Grafting.
Pak J Med Health Sci Jan ;6(2):286-91.

Objective: To compare number of grafts applied and midterm graft patency in patients undergoing off pump bypass surgery (OPCAB) with conventional on pump coronary artery surgery(C-CABG). Material & methods: Study was conducted at the Dept. of Cardiac Surgery Punjab Institute of Cardiology Lahore form 1st. June, 2009 to 31st.December, 2009. The study comprised of 100 consecutive patients who underwent CABG. The patients, who were critically ill with hemodynamic instability, had cardiac dysrythmia or arrest or history of previous cardiac surgery or concomitant cardiac procedures were not included in the study. The patients were randomly divided in two groups by computer generated list using open epi Version 2.0. Group (I) included 47 patients who underwent coronary artery bypass grafting on CPB(C-CABG) and group (II) included 53 patients who underwent Coronary artery bypass grafting without CPB (OPCABG). All patients were operated by the same surgeon. Data was collected and analyzed using SPSS 17.0, Mean±SD is given for quantative variables. Frequencies and percentages are given for qualitative variables. Results: All patients included in the study had left internal mammary artery (LIMA )grafted to left anterior descending artery (LAD). Number of grafts applied per patient were 3.0±0.90 in group I and 3.09±0.87 (p=0.67). Male to female ratio in Group I and Group II was 8.40:1 and 7.55:1 respectively. The mean age in Group I was 55.51±8.96 yrs and Group II was 55.57±9.30 yrs. No significant difference was seen in perioperative MI among the groups, Group I ((2.1%) vs. Group II 3(5.66%). Eighty-nine out 100 patients under went angiographic study after 6 months to a year. Group I patients had 110 patent grafts out of 134 grafts applied (patency rate of 82.09%) while in Group II 121 out of 154 grafts were found patent (patency rate of 78.5%) with a P value of 0.0634. Over all graft patency for LIMA was 92.12% while for vein grafts it was 74.87%. Conclusion: OPCAB surgery has no added advantage over CABG done on conventional CPB as regards to early clinical outcome. Comparable graft patency and complete revascularisation can be achieved in OPCAB.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com