• Z S Meharwal and N Trehan.
• Department of Cardiovascular Surgery, Escorts Heart Institute and Research Centre, New Delhi. meharwal@hotmail.com
• Indian Heart J. 2001 May 1; 53 (3): 314-8.

BackgroundThe feasibility of off-pump coronary artery bypass surgery has been well demonstrated. The purpose of the present study was to assess the safety and efficacy of off-pump coronary artery surgery in patients with left main coronary artery disease.Methods And ResultsBetween January 1997 and December 2000, 174 patients with significant left main coronary artery stenosis underwent coronary artery bypass grafting without a pump. During the same period, 991 patients who also had significant left main coronary artery stenosis underwent coronary artery surgery on a pump. The patients in the two groups were matched in preoperative variables except that those in the off-pump group were slightly older, and more required urgent surgery. Hospital mortality was 2/174 and 21/991 in the off-pump and on-pump groups, respectively (p=0.560). The incidence of perioperative myocardial infarction (1.74 v. 14/991, p=0.712), atrial fibrillation (17/174 v 157/991, p=0.050) and blood transfusion requirement (63/174 v. 476/991, p=0.05) were significantly less in the off-pump group. The intubation time (15+/-3 hours v 22+/-4 hours, p=0.001), blood loss (365+/-61 ml v 582+/-76 ml, p<0.001), intensive care unit stay (23+/-10 hours v. 36+/-11 hours, p<0.001) and hospital stay (6+/-4 days v. 9+/-5 days, p <0.001) were also less in the off-pump group.ConclusionsOff-pump coronary artery bypass surgery is safe and effective for patients with left main coronary artery disease.

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