Off-pump versus on-pump coronary artery revascularization: Effects on pulmonary function

Abstract

Many studies have shown important changes in lung function tests after coronary artery surgeries. It is controversial if off-pump surgery can give a better and shorter recovery than the on-pump. A prospective study was conducted on 42 patients submitted to coronary artery surgery and divided into two groups: 21 off-pump using intraluminal shunt (G,) and 21 on-pump (G M), matched by the anatomical location of the coronary arteries lesions. All patients had spirometric evaluation, blood gas measurements and alveolo-arterial oxygen gradient (A-aDO 2), at the fourth and 10th postoperative days (PO 4 and PO 10). Preoperatively, G, and G M had similar results (P>0.372). Spirometry showed decreases at PO 4 and remained decreased until PO 10 for both groups, with significant differences between the groups. The blood gas measurements showed reduction in arterial oxygen pressure (PaO 2) and carbon dioxide pressure (PaC0 2), while there was an increase in A-aDO 2 at PO 4 and PO 10 in both groups. The results suggest that different changes occur in pulmonary function when the surgery is performed with or without cardiopulmonary bypass. The off-pump patients showed significantly greater improvement than the on-pump group. © 2010 Published by European Association for Cardio-Thoracic Surgery.