Outcomes of off-pump versus on-pump coronary artery bypass grafting

The aim of this study was to analyse if off-pumpcoronary artery bypass surgery (CABG) is associated with better treatment outcomes than on-pump CABG. Method: We reviewed 10 recent articles on pub-med off-pump and on-pump CABG revascularization. Discussions: OPCAB was in theory superior ONCAB in many ways as it spared patients the burden of CPB with the inevitable increase in transfusion demands and inflammatory response and therefore lowering the surgical load.Since the popularization OPCAB two decades ago it has become the most common CABG variant performed in countries like Japan and India while in Europe and the USA ONCAB is the most common and OPCAB is performed in 8 to 25 % of cases. Large observational studies like ROOBY, CORONARY and DOORS, especially in recent follow-up studies, have tended to favor ONCBG. Conclusion: In a well selected patient in a high-risk subgroup with a surgeon skilled in OPCAB there are potential benefits compared to ONCAB but the overall trend in recent large RCTs and follow-up studies point to the average CABG patient being better served by ONCAB due to better graft patency and fewer complications.