CORONARY ARTERY BYPASS SURGERY FOR ACUTE CORONARY SYNDROME:OFF-PUMP VERSUS ON-PUMP APPROACH

Abstract

Background: Aim of this study was to compare the outcome of off-pump versus on-pump coronary artery
bypass strategies in acute coronary syndromes setting.
Methods and Results: Consecutive patients for coronary artery bypass surgery (CABG) were reviewed.
Cases with acute coronary syndrome (ACS) receiving emergency CABG surgery via midline sternotomy
from June 2006 to September 2007 were evaluated. Altogether 27 patients were operated for ACS either offpump
(OPCAB) n=16, or conventional on-pump (CPB) n-11. Seventy four grafts were performed in all with
a mean of 2.74. Twenty patients between both groups had 3 or more grafts; with an aim of complete
revascularization. Time from skin incision to culprit lesion revascularization was significantly reduced in
OPCAB patients. OPCAB surgery led to a significant benefit in terms of less drainage loss, less transfusion
requirement, less inotropic support, shorter ventilation time, and shorter intensive care unit stay.
Conclusions: Off-Pump strategies are associated with an improved hospital outcome for high-risk patients
presenting acute coronary syndrome with or without cardiogenic shock.