Off-pump versus on-pump coronary artery bypass procedures

Postoperative renal complications in an asian population

Sivakkanan Loganathan, Chih Chiang Nieh, Maximilian Y. Emmert, Felix Woitek, Eliana Cecilia Martinez Valencia, Sonja Muecke, Chuen Neng Lee, Theo Kofidis

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Diabetes and habitual smoking cause advanced coronary artery disease (CAD) in Asian patients at a younger age. No definite data exist as to whether off-pump (OPCAB) is better than conventional on-pump coronary artery bypass grafting (CCAB) in terms of postoperative renal complications. Thus, we aimed to compare the renal outcomes of on-pump and off-pump coronary artery bypass grafting (CABG) on our patients, which constituted a predominantly Asian population. Materials and Methods: A cohort of 395 patients following CCAB were compared with 293 patients who underwent OPCAB. Baseline demographics, comorbidities, intraoperative data, intensive care unit stay, number of grafts, New York Heart Association (NYHA) score, American Society of Anesthesiologists (ASA) score, EuroSCORE risk assessment model, and postoperative complications particularly renal, were collected and analysed. Results: The off-pump group consisted of significantly older patients with higher Canadian Cardiovascular Society (CCS) and ASA scores. Additionally, the off-pump group involved a significantly greater number of smokers and chronic obstructive pulmonary disease (COPD) patients. Other demographic parameters were not different between the groups. Postoperative investigations showed a significantly elevated serum creatinine (100.3 ± 42.5 vs 127.6 ± 114.2 μmol/L; off-pump vs on-pump; P = 0.039) and urea levels (5.9 ± 3.1 vs 10.6 ± 15.6 mg/dL; off-pump vs on-pump; P = 0.006) in the on-pump group. Moreover, there was a high tendency towards a higher rate of renal dysfunction associated death in this group. Conclusions: OPCAB is a safe and equally efficient operative method compared to CCAB, and has a significant lower risk for postoperative renal complications as a treatment modality for surgical coronary revascularisation.

Original languageEnglish (US)
Pages (from-to)112-117
Number of pages6
JournalAnnals of the Academy of Medicine Singapore
Volume39
Issue number2
StatePublished - Feb 2010
Externally publishedYes

Fingerprint

Coronary Artery Bypass
Kidney
Population
Demography
Off-Pump Coronary Artery Bypass
Chronic Obstructive Pulmonary Disease
Intensive Care Units
Urea
Comorbidity
Coronary Artery Disease
Creatinine
Smoking
Transplants
Serum

Keywords

  • Cardiopulmonary bypass
  • Renal dysfunction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Off-pump versus on-pump coronary artery bypass procedures : Postoperative renal complications in an asian population. / Loganathan, Sivakkanan; Nieh, Chih Chiang; Emmert, Maximilian Y.; Woitek, Felix; Martinez Valencia, Eliana Cecilia; Muecke, Sonja; Lee, Chuen Neng; Kofidis, Theo.

In: Annals of the Academy of Medicine Singapore, Vol. 39, No. 2, 02.2010, p. 112-117.

Research output: Contribution to journalArticle

Loganathan, Sivakkanan ; Nieh, Chih Chiang ; Emmert, Maximilian Y. ; Woitek, Felix ; Martinez Valencia, Eliana Cecilia ; Muecke, Sonja ; Lee, Chuen Neng ; Kofidis, Theo. / Off-pump versus on-pump coronary artery bypass procedures : Postoperative renal complications in an asian population. In: Annals of the Academy of Medicine Singapore. 2010 ; Vol. 39, No. 2. pp. 112-117.
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AU - Loganathan, Sivakkanan

AU - Nieh, Chih Chiang

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AU - Woitek, Felix

AU - Martinez Valencia, Eliana Cecilia

AU - Muecke, Sonja

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AU - Kofidis, Theo

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AB - Introduction: Diabetes and habitual smoking cause advanced coronary artery disease (CAD) in Asian patients at a younger age. No definite data exist as to whether off-pump (OPCAB) is better than conventional on-pump coronary artery bypass grafting (CCAB) in terms of postoperative renal complications. Thus, we aimed to compare the renal outcomes of on-pump and off-pump coronary artery bypass grafting (CABG) on our patients, which constituted a predominantly Asian population. Materials and Methods: A cohort of 395 patients following CCAB were compared with 293 patients who underwent OPCAB. Baseline demographics, comorbidities, intraoperative data, intensive care unit stay, number of grafts, New York Heart Association (NYHA) score, American Society of Anesthesiologists (ASA) score, EuroSCORE risk assessment model, and postoperative complications particularly renal, were collected and analysed. Results: The off-pump group consisted of significantly older patients with higher Canadian Cardiovascular Society (CCS) and ASA scores. Additionally, the off-pump group involved a significantly greater number of smokers and chronic obstructive pulmonary disease (COPD) patients. Other demographic parameters were not different between the groups. Postoperative investigations showed a significantly elevated serum creatinine (100.3 ± 42.5 vs 127.6 ± 114.2 μmol/L; off-pump vs on-pump; P = 0.039) and urea levels (5.9 ± 3.1 vs 10.6 ± 15.6 mg/dL; off-pump vs on-pump; P = 0.006) in the on-pump group. Moreover, there was a high tendency towards a higher rate of renal dysfunction associated death in this group. Conclusions: OPCAB is a safe and equally efficient operative method compared to CCAB, and has a significant lower risk for postoperative renal complications as a treatment modality for surgical coronary revascularisation.

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