title: Reoperative coronary artery bypass surgery: the role of on-pump and off-pump techniques on factors affecting hospital mortality and morbidity.
abstract: OBJECTIVE
  Short term results of on-pump and off-pump techniques in patients undergoing reoperative coronary artery bypass grafting (redo CABG) were investigated in this study.
  
  
  METHODS
  A total of 14.430 patients have undergone isolated coronary artery bypass grafting in our clinic from 1998 to 2010. Of these patients, 105 patients who have undergone redo CABG, 53 (50.5%) were operated with cardiopulmonary bypass (on-pump) and 52 (49.5%) without cardiopulmonary bypass (off-pump). Early results for which on or off-pump techniques were independent risk factors were determined with logistic regression analysis.
  
  
  RESULTS
  Overall mortality in patients undergoing redo CABG was 12.3% with a 11.5% mortality in the off-pump group and 13.2% mortality in the on-pump group and the difference was not statistically significant (p >0.05). Blood product transfusion requirement (p <0.05, OR: 3.620, 95% CI: 1.295-10.119), new onset atrial fibrillation rhythm (AFR) (p <0.05, OR: 13.357, 95% CI: 1.656-107.721), prolonged ventilation (p <0.05, OR: 9.066, 95% CI: 1.091-75.323) and duration of hospitalization (p <0.01, OR: 5.252, 95% CI: 1.784-15.459) were significantly higher in the on-pump group. The number of patients with postoperative low cardiac output was significantly higher in the off-pump group (p <0.05, OR: 5.337, 95% CI: 1.094-26.043). The ratio of complete bypass was significantly higher in the on-pump group compared to the off-pump group (p <0.05, OR: 2.913, 95% CI: 1.204-7.046).
  
  
  CONCLUSIONS
  Despite the lower morbidity and mortality in the off-pump group, the rate of target vessel bypass grafting was lower. Off-pump technique may be considered as a safer option for cardiopulmonary bypass in the high risk population.
authors: Private Emsey Hospital, Cardiovascular Surgery Clinic, Pendik, Istanbul, Turkey.
authors: Ibrahim
authors: I
authors: Kara
authors: Canturk
authors: C
authors: Cakalagaoglu
authors: Yasin
authors: Y
authors: Ay
authors: Saleh
authors: S
authors: Al Salehi
authors: Mehmet
authors: M
authors: Yanartas
authors: Huseyin
authors: H
authors: Anasiz
authors: Cengiz
authors: C
authors: Koksal
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000379:methods*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation / Q000379:methods; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome