A Comparative Study of Post-Operative Outcomes for Off-Pump and On-Pump Coronary Artery Bypass Grafting

Introduction: Coronary artery bypass grafting (CABG) is a common surgical procedure for the management of coronary artery disease. Off-pump (OPCAB) and on-pump (ONCAB) CABG have been compared in various studies, but limited data exists for the Bangladeshi population. The present study was conducted to shed further light on the topic relative to the Bangladeshi demographic. Methods: This retrospective observational study conducted at the Department of Cardiac Surgery, National Institute of Cardiovascular Disease, Dhaka, Bangladesh, over a 1.5-year period from April 2019 to September 2020 compared the outcomes of OPCAB and ONCAB in a Bangladeshi population, analyzing the demographic and clinical characteristics, operative characteristics, early postoperative outcomes, and recovery parameters of 34 patients undergoing either OPCAB (n=17) or ONCAB (n=17). Result: The two groups were well-matched in terms of demographic and clinical characteristics, with no significant differences in age, gender, BMI, or comorbidities. The OPCAB group had a significantly shorter total operative time (180.4 ± 26.8 min vs. 195.3 ± 31.2 min, P < 0.05). Early postoperative outcomes were similar between the two groups (P > 0.05 for all comparisons), while the OPCAB group had a significantly shorter hospital stay (7.8 ± 1.8 days vs. 9.2 ± 2.1 days, P < 0.05), mechanical ventilation time (9.1 ± 3.8 hours vs. 12.6 ± 4.5 hours, P < 0.05), and time to ambulation (3.8 ± 0.9 days vs. 4.5 ± 1.0 days, P < 0.05). Conclusion: Our study suggests that OPCAB may be a viable alternative to ONCAB for selected patients in the Bangladeshi population, offering potential benefits in terms of reduced recovery times and resource utilization. Further large-scale, randomized controlled trials are needed to confirm these findings and assess the long-term outcomes and cost-effectiveness of OPCAB compared to ONCAB.