Cardiac rehabilitation outcomes no different after on-pump versus off-pump coronary artery bypass surgery.
OBJECTIVE
Clinical evidence supports lower morbidity with off-pump coronary revascularization surgery as well as superior short- and mid-term outcomes, equivalent graft patency, and reduced cost. The purpose of this study was to compare cardiac rehabilitation (CR) outcomes between patients undergoing on-pump versus off-pump coronary artery bypass surgery.


METHODS
Data were retrospectively examined for patients who participated in CR between 1996 and 2004. Two hundred ninety-five patients who underwent bypass surgery and completed at least 80% of their 36 required sessions were divided into on-pump and off-pump groups. Pre- and post-CR measures included grip strength, flexibility, energy expended during class, quality of life, and self-efficacy.


RESULTS
Both groups were similar with respect to age, sex, ejection fraction, and mean number of grafts. There were no statistical differences between the on-pump and off-pump groups (P > .05) for weight, abdominal and hip circumferences, grip strength, flexibility, and total energy expenditure. In addition, there were no between-group differences regarding quality of life and self-efficacy. Grip strength, flexibility, and energy expenditure during class improved with CR regardless of the surgical procedure (P = .001). Quality of life (P = .001) and self-efficacy (P = .001) also improved.


CONCLUSIONS
The present data support the concept that although there are clinical advantages to off-pump surgery, there is no benefit over on-pump surgery regarding CR. Subsequently, patients undergoing off-pump surgery should be managed similarly as their on-pump counterparts.
Aron
Adrian
A
Department of Exercise Science and Athletics, Bloomsburg University, Bloomsburg, PA, USA. aronady@vt.edu
Klinger
Troy A
TA
McConnell
Timothy R
TR
D000368:Aged; D000704:Analysis of Variance; D001835:Body Weight; D001026:Coronary Artery Bypass; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery*; D004734:Energy Metabolism; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D018583:Pliability; D011788:Quality of Life; D012189:Retrospective Studies; D020377:Self Efficacy; D016896:Treatment Outcome; D049629:Waist-Hip Ratio