Transfusion of blood products in off-pump coronary artery bypass and conventional coronary artery revascularization. A prospective randomized study.
BACKGROUND
There has been a growing interest in off-pump coronary artery bypass (OPCAB) grafting in recent years. Beating-heart surgery is believed to be less invasive as it allows the side effects of extracorporeal circulation to be avoided.


OBJECTIVE
The aim of the study was to compare blood product transfusion rates between two groups of patients undergoing surgery for ischemic heart disease with either the off-pump technique or using cardiopulmonary bypass (CPB).


METHODS
There were 152 patients enrolled in the prospective randomized study. All procedures were elective. There were 84 patients (62 men and 20 women) at the mean age of 63.74 ± 7 years who underwent OPCAB (group I), and 68 patients (54 men and 14 women) at the mean age of 63.51 ± 6 years who underwent cardiopulmonary bypass (group II).


RESULTS
There were no perioperative deaths. The mean number of grafts was 2.27 ± 0.3 (OPCAB group) and 2.63 ± 0.6 (CPB group) (p < 0.05). The mean number of packed red blood cells transfused in the OPCAB group was 2.31 ± 0.18 units/patient and 3.94 ± 0.30 units/patient in the CPB group (p < 0.05). The mean number of fresh frozen plasma units transfused was 1.13 ± 0.13 in the OPCAB group vs. 1.57 ± 0.15 in the CPB group (p < 0.05). There were 12 patients (14%) in the OPCAB group who had no transfusion.


CONCLUSIONS
One of the most important advantages of the OPCAB technique is that it makes it possible to reduce the rate of blood product transfusions.
Cardiac Surgery and Transplantology Department, Chair of Cardio-Thoracic Surgery, Poznan University of Medical Sciences, Poland.
Maciej
M
Walczak
Cardiac Surgery Department, University Hospital of Lord's Transfiguration, Poznan, Poland.
Tomasz Kamil
TK
Urbanowicz
Cardiac Surgery Department, University Hospital of Lord's Transfiguration, Poznan, Poland.
Jadwiga
J
Tomczyk
Cardiac Surgery Department, University Hospital of Lord's Transfiguration, Poznan, Poland.
Estillita
E
Camacho
Cardiac Surgery Department, University Hospital of Lord's Transfiguration, Poznan, Poland.
Marcin
M
Ligowski
Cardiac Surgery Department, University Hospital of Lord's Transfiguration, Poznan, Poland.
Sebastian
S
Stefaniak
Cardiac Surgery Department, University Hospital of Lord's Transfiguration, Poznan, Poland.
Marek
M
Jemielity
CABG; CPB; OPCAB; blood products; myocardial revascularization; transfusion