A comparative study of operative & postoperative parameters in coronary artery bypass grafting patients: Insights from a tertiary care experience

Abstract

Background: Coronary artery bypass grafting (CABG) remains the standard surgical treatment for multivessel coronary artery disease. Off-pump and on-pump techniques differ in intraoperative management and postoperative outcomes. This study aimed to compare operative and postoperative parameters between off-pump and on-pump CABG patients. Methods: This comparative cross-sectional study was conducted in a cardiac surgery department. A total of 60 patients undergoing CABG were divided into two groups: off-pump CABG (n=30) and on-pump CABG (n=30). Baseline characteristics, operative variables, postoperative clinical outcomes and myocardial injury markers including CK-MB and cardiac troponin I (cTnI) were analyzed. Statistical comparisons were performed using appropriate tests, with p≤0.05 considered significant. Results: Baseline demographic characteristics, risk factors and preoperative cardiac function were comparable between groups. Operative time was significantly shorter in the off-pump group compared to the on-pump group (254.00 ± 28.75 vs. 334.50 ± 23.72 minutes; p<0.001). Postoperative inotropic support requirement was significantly higher in the on-pump group (76.7% vs. 10.0%; p<0.00001). CK-MB and cTnI levels were significantly elevated in the on-pump group at 6, 12 and 24 hours postoperatively, indicating greater myocardial injury. However, mechanical ventilation time, blood loss, transfusion requirement and postoperative complications showed no significant differences between groups. Conclusion: Both on-pump and off-pump CABG are safe and effective techniques with comparable early clinical outcomes. Off-pump CABG is associated with shorter operative time and reduced perioperative myocardial injury, while on-pump CABG requires greater postoperative inotropic support.