Hospital outcomes after off-pump coronary artery bypass grafting in diffuse coronary artery disease

Introduction: Diffuse coronary artery disease (CAD) limits coronary artery bypass surgery (CABG) and requires complex coronary artery reconstruction (CAR). On-pump CABG with using CAR demonstrates satisfactory in these patients. Possibilities for off-pump CABG with using CAR are little-studied. Aim: Evaluation of clinical outcomes after on-pump and off-pump CABG in patients with diffuse CAD. Methods: 146 patients were included in the study, which divided into 2 groups: the first group formed by patients who underwent off-pump CABG (group 1 - off-pump, n = 82); the second group formed by patients who underwent on-pump CABG (group 1 - on-pump, n = 540). Propensity score matching was done to get comparable groups. The comparative analysis of hospital outcomes (angina recurrence, repeat revascularization, myocardial infarction, all-cause mortality) was performed. Results: Most of patients were men (n = 76.8%), the mean age was 64.5±7.9. The rate of 30-day mortality was 0% in both groups. Major cardiovascular events were analyzed; one patient from each group was suffered from perioperative myocardial infarction (1.2%). Acute renal failure was diagnosed in 2 patients from group 2 (2.4%), perioperative stroke was registered in 1 patient in the same group (1.2%). Resternotomy for excessive bleeding was performed in 1 patient from the 1 group (1.2%) and 3 patients from the 2 group (3.6%). Conclusion: Off-pump CABG in patients with diffuse CAD is safe and associated with comparable effectiveness that rivals to on-pump surgery.