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Off-Pump Coronary Artery Bypass Grafting in Left Ventricular Dysfunction

Department of Cardiovascular Surgery, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

For reprint information contact: Masoumali Masoumi, MD Tel: 98 831 836 0752 Fax: 98 831 836 0043 Email: mmasoumi{at}kums.ac.ir, Imam Ali Heart Center, Shahid Beheshti Ave, Kermanshah, Iran.

Between August 2004 and May 2006, 124 patients undergoing coronary artery bypass grafting with ejection fractions 35% were randomly assigned to off-pump or conventional procedures. Preoperative characteristics were the same in both groups, except for age and degree of mitral regurgitation. Off-pump coronary artery grafting was carried out using a tissue stabilizer and a single-suture technique; conventional coronary bypass employed cardiopulmonary bypass, moderate hypothermia, and antegrade-retrograde cold blood cardioplegic arrest. There were significantly fewer vessels grafted (3.09 ± 0.41) in the off-pump group than in those who had a conventional procedure (3.42 ± 0.86). The rates of mortality, morbidity, balloon pump support, inotropic usage, gastrointestinal bleeding, renal dysfunction, reintubation, as well as intensive care and hospital stay, were significantly lower in the off-pump group. The incidence of perioperative myocardial infarction did not differ significantly between groups. The results of this study indicate that beating-heart coronary bypass is safe and effective in patients with left ventricular dysfunction.