On-pump coronary artery bypass graft surgery versus off-pump coronary artery bypass surgery in patients with left ventricular dysfunction: A comparative study

Abstract

BACKGROUND: Treatment of significant coronary artery disease complicated with left ventricular dysfunction is challenging. Off-pump coronary artery bypass surgery is feasible and applicable for patients with left ventricular dysfunction, as it avoids the pump induced complications. AIM: This study will compare the outcome, advantages and disadvantages of On-pump versus Off pump coronary artery bypass surgery in patients with left ventricular dysfunction. MATERIALS AND METHODS: 81 patients with significant coronary artery disease and ischemic left ventricular dysfunction were categorized into On-pump (42 patients) and Off-pump (39 patients) and underwent coronary artery bypass graft surgery. In the On-pump group cardiopulmonary bypass with aorta, right atrial cannulation, moderate hypothermia and cold cardioplegic arrest was employed, and in the Off-pump group, grafting was done with cardiac stabilizers. Patients were monitored in the immediate post operative and followed up for a period of one month and ejection fraction documented. RESULTS: The mortality, morbidity, complications, post operative bleeding, post operative ventilation, intensive care unit stay and hospital stay were less in the Off-pump group. There was significant improvement in the left ventricular function during the post operative follow up. CONCLUSION: In conclusion, Off-pump coronary artery bypass surgery is a safer alternative to On- pump coronary artery bypass surgery in patients with ischemic left ventricular dysfunction