Off-pump versus on-pump coronary artery bypass grafting in patients with chronic obstructive pulmonary disease

Abstract

Objective: To compare the outcome of coronary artery bypass grafting with and without cardiopulmonary bypass in patients of chronic obstructive pulmonary disease. Methods: The prospective randomised multicentre study was conducted in 2020 at Kafrelsheikh University Hospital, International Cardiac Centre and Alexandria New Medical Centre, Egypt. Patients regardless of age and gender who had ischaemic heart disease and chronic obstructive pulmonary disease were enrolled, and randomised into on-pump procedure group 1 and off-pump procedure group II. All patients were assessed preoperatively for pulmonary function tests and postoperatively for duration of mechanical ventilation, respiratory failure, pneumonia, atrial fibrillation, acute respiratory distress syndrome, pleural effusion, lung atelectasis, sternal dehiscence, intensive care unit stay and overall hospital stay. Data was analysed using SPSS ver 25 Armonk, NY: IBM Corp.; Released 2017. Results: Of the 60 patients, 30(50%) were in each of the two groups. Overall, there were 20(33.3%) women and 40(66.6%) men with mean age 56.5±6.05 years. The mean duration of mechanical ventilation in group I was 12.07±5.18 minutes compared to 6.97±2.25 minutes in group II (p<0.001). The mean duration of stay in intensive care unit in group I was 4.17±1.64 days compared to 3.03±1.03 days in group II (p<0.001). The mean hospital stay was 7.40±1.90 days in group I and 5.93±1.17 days in group II (p<0.001). There was no significant difference between the groups regarding the frequency of respiratory failure, pneumonia, atrial fibrillation, acute respiratory distress syndrome, pleural effusion, lung atelectasis and sternal dehiscence (p=1.000) Conclusion: Off-pump coronary artery bypass grafting was found to be efficient and had a faster postoperative course than on-pump procedure in patients with chronic obstructive pulmonary disease.