Off-Pump Bypass Surgery Reduces Certain Risks

Off-pump coronary artery bypass graft (CABG) surgery reduces the risk of complications such as stroke and atrial fibrillation, according to a new study.

Researchers from the U.S. Agency for Healthcare Research and Quality (AHRQ, Rockville, MD, USA) analyzed data from 41 clinical trials that included 3,996 patients who underwent CABG after 1999. The researchers compared the off-pump approach to the traditional cardiopulmonary bypass (CPB) procedure, which stops the heart to allow surgeons to create the new pathways. The researchers found that the off-pump procedure resulted in a 50% reduction in the risk faced by patients undergoing the surgery; a 30% reduction in the risk of atrial fibrillation; and a 48% reduction in wound infection.

The study also found that off-pump surgery often involves fewer grafts to bypass coronary lesions as compared with traditional surgery. In addition, the study showed evidence that off-pump surgeries are more successfully performed at facilities that perform many of them. These findings appeared in the November 2006 issue of the journal Stroke.

"Off-pump CABG carries its own risks, and requires substantial training to learn and perform comfortably,” said lead author Artyom Sedrakyan, M.D., Ph.D., a cardiothoracic surgeon and health services researcher at AHRQ. "We look forward to more research on long-term outcomes and in settings outside trials to learn more about this important surgery.”

CABG, pioneered in 1967, creates new paths around blocked arteries to improve blood flow to the heart. The risks of adverse effects on heart, brain, lungs, kidney, and other organs, have led some surgeons to consider off-pump CABG as a less-invasive alternative.



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U.S. Agency for Healthcare Research and Quality