Fewer complications linked to off-pump bypass surgery

AORN Journal, May, 2007

The incidence of surgery-related strokes and other short-term complications may be reduced when surgeons perform common heart surgery without bypassing the cardiopulmonary system, according to an Oct 25, 2006, news release from the Agency for HeaLthcare Research and Quality. Coronary artery bypass graft (CABG) surgery has traditionally involved cardiopulmonary bypass (CPB). In recent years, however, some surgeons have been performing CABG procedures without using CBP, a technique known as off-pump CABG surgery.

Researchers analyzed data from 41 randomized clinical trials that included 3,996 patients who had heart surgery after 1999. Off-pump CABG was associated with a

* 30% reduction in atrial fibrillation Lie, avoidance of 80 cases of atrial fibrillation per 1,000 off-pump CABG surgeries);

* 48% reduction in wound infection (ie, avoidance of 40 infections per 1,000 off-pump CABG surgeries); and

* 50% reduction in postoperative strokes (ie, avoidance of 10 strokes per 1,000 off-pump CABG surgeries).

Researchers caution that the decision to perform off-pump CABG procedures must be made on a case-by-case basis. Additionally, researchers acknowledge that the risks and Long-term effects associated with off-pump CABG surgery require further study.

"Off-Pump" Bypass Surgery Associated With Reduced Occurrence of Stroke and Other Complications [news release]. Rockville, Md: Agency for Healthcare Research and Quality; October 25, 2006.