Comparison of Clinical Outcomes of Off-pump versus On-pump Coronary Artery Bypass Grafting in Diabetes Patients.
- Author:
Suk Won SONG
1
;
Kyung Jong YOO
;
Sang Hyun LIM
;
Soon Chang HONG
;
Soo Jin CHO
;
Byung Chul CHANG
;
Meyun Shick KANG
;
Hye Ran SHIN
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Yonsei Cardiovascular Research Institute, Yonsei University College of Medicine, Korea. kjy@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Diabetes mellitus;
Coronary artery bypass;
Off-pump
- MeSH:
Cardiopulmonary Bypass;
Coronary Artery Bypass*;
Coronary Vessels*;
Diabetes Mellitus;
Follow-Up Studies;
Humans;
Length of Stay;
Mortality;
Myocardial Infarction;
Operative Time;
Renal Insufficiency;
Reoperation;
Risk Factors;
Transplants;
Ventilation;
Wound Infection
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2004;37(7):553-558
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Avoiding cardiopulmonary bypass (CPB) in coronary artery bypass grafting (CABG) has been known to reduce early mortality and morbidity. Diabetes Mellitus is a significant risk factor for adverse early and late outcomes after CABG. We compared the clinical results of off-pump CABG versus on-pump CABG in diabetes patients. MATERIAL AND METHOD: 682 patients (424 off-pump CABG and 258 on-pump CABG) underwent isolated coronary artery bypass grafting between January 2001 and June 2003. Data were collected 242 patient who had diabetes. Among them, 154 patients underwent off-pump CABG and 90 patients underwent on-pump CABG. We analyzed the preoperative risk factors and postoperative results between 2 groups. RESULT: Two groups did not show statistical differences in age, sex, coronary and operative risk factors. Operative time was significantly shorter in off-pump CABG, however, number of grafts was fewer in off-pump CABG. Postoperative inotropic usage was lower in off-pump CABG. Postoperative CK-MB level was lower in off-pump CABG, and ICU stay and ventilation time was significantly shorter in off-pump CABG. However, there was no statistical difference between 2 groups in operative mortality, reoperation rate, perioperative myocardial infarction, wound infection, renal failure, neurological complications and hospital stay. CONCLUSION: Off-pump CABG group showed less myocardial damage and early recovery. We concluded that off-pump CABG is the more reasonable technique in diabetes patients although two techniques showed good results. The long-term follow up and prospective study may be warranted.
