OFF-PUMP CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH CORONARY ARTERY DISEASE AND CONCOMITANT MITRAL VALVE REGURGITATION

Highlights

• The review presents a retrospective analysis of data of patients who underwent combined coronary artery bypass grafting and mitral valve repair/replacement.
• The authors comparatively assessed outcomes of off-pump coronary artery bypass grafting (OPCABG) and on-pump CABG (ONCABG) in patients with combined valvular pathology.

Abstract

Aim. To evaluate the benefits of off-pump coronary artery bypass grafting (OPCABG) in patients with coronary artery disease and concomitant mitral valve (MV) regurgitation.

Methods. The study included 50 patients with coronary artery disease and concomitant MV disease who underwent simultaneous CABG and correction of MV regurgitation. Patients were divided into 2 groups: group 1 (n = 26) included patiens with on-pump CABG (ONCABG), group 2 (n = 24) included patiens with OPCABG.

Results. In the OPCABG group there was shorter aortic cross-clamping time (85,5 [71,25; 105,25] vs 119 [99,25; 132,25] min, compared with the ONCABG group, p < 0,05), shorter duration of CPB (136,5 [119,25; 158,5] vs 168,5 [142,75; 186,25] min, p < 0,05), and overall duration of the operation (292,5 [252,5; 360] vs 340 [287,5; 385] min, respectively, p = 0,15). Moreover, in this group there was a lower need for transfusion of blood and its components: freshly frozen plasma (2 [2; 3] vs 3 [3; 3], p < 0,05), RBC mass (2 [1; 2] vs 2 [2; 2],  respectively, p = 0,4),  and  lower number of bed-days during hospital stay (20 [13,5; 26,25] vs 23,5 [17,5; 26] days, p < 0,05).

Conclusions. Off-pump CABG in patients with combined valvular pathology is a safe and reproducible technique that provides shorter aortic cross-clamping time, on-pump time and operation duration. The need for blood transfusion and the length of hospital stay are reduced as well.

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