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Early outcomes in patients undergoing off-pump coronary artery bypass grafting

  • Gautam Rampratap Agarwal
  • Neethu Krishna
  • Greeshma Raveendran
  • Rajesh Jose
  • Murukan Padmanabhan
  • Aveek Jayant
  • Praveen Kerala VarmaEmail author
Original Article
  • 29 Downloads

Abstract

Background

In spite of general decline worldwide, off-pump coronary artery bypass grafting (CABG) surgery is performed in more than 60% of patients undergoing CABG in India; mainly because of shorter operative time and reduced procedure cost. However, paucity of data exists in literature about early outcomes following off-pump CABG from India.

Methodology

We conducted a prospective observational study of 800 consecutive cases that underwent off-pump CABG (OPCAB) from August 2015 to October 2017. Primary end point of the study was the 30-day/in-hospital mortality from any cause.

Results

On multivariate analysis, emergency surgery (OR 9.72; CI 1.96–48.21, p value 0.005), severe left ventricular dysfunction (OR 2.28; CI 1.25–4.76, p value 0.026), postoperative atrial fibrillation (OR 9.95; CI 3.12–32.01, p value 0.05), and dialysis-dependent renal failure (OR 29.7, CI 10.02–87.99, p value 0.006) were the factors associated with mortality. The observed mortality was 1.6%, and the expected mortality by EuroSCORE II was 2.6%. The median EuroSCORE II of expired patients was 3.03 and of entire cohort was 1.54 (p value 0.001). Stroke rate was 0.9%. Deep sternal wound infection occurred in 0.9%, and 3.8% patients were readmitted to the hospital after discharge.

Conclusion

Early outcome of off-pump CABG was excellent in this study. Increased incidence of deep sternal wound infection remains a concern. Multicenter study with a larger sample size is required for a dependable evaluation of the efficacy of off-pump CABG in Indian population.

Keywords

Off-pump CABG Coronary artery bypass grafting Outcomes 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Source of funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Ethical approval

The study was approved by the hospital ethics committee. The need for informed consent was waived off. All personal identifying data was removed from the study database so that individuals could not be identified. “All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2018

Authors and Affiliations

  1. 1.Division of Cardiothoracic Surgery, Amrita Institute of Medical Sciences and Research CenterAmrita UniversityKochiIndia
  2. 2.Division of Biostatistics, Amrita Institute of Medical Sciences and Research CenterAmrita UniversityKochiIndia
  3. 3.Division of Anesthesiology, Amrita Institute of Medical Sciences and Research CenterAmrita UniversityKochiIndia

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