Beta
ManageSearchChatDiscover
120303

Off-Pump Versus On-Pump Coronary Artery Bypass Surgery in Ischemic Heart Disease Patients with Impaired Contractility and Renal Dysfunction: A Comparative Study

Article

Last updated: 22 Jan 2023

OverviewSimilar Items

Subjects

-

Tags

Surgery

Abstract

Background: Coronary artery bypass surgery using cardiopulmonary bypass [CPB] carries the risk of renal impairment, which cannot be attributed to a single factor. This study compared the off-pump technique with the on-pump technique on kidney function in ischemic heart disease patients.
 Aim of the work: The study aimed to compare off-pump with on-pump technique on kidney and heart functions in patients with renal impairment with no need for dialysis but with impaired Ejection fraction [EF].
Patients and methods: This prospective non-randomized study included 60 patients who presented with symptoms of ischemic heart disease and subsequently underwent myocardial revascularization with preoperative serum creatinine levels between 1.6 to 2.5 mg/dl and EF below 45%. Patients were as following: Group A patients [on-pump]: included those who underwent surgery on cardiopulmonary bypass. Group B patients [off-pump]: included those who underwent off-pump surgery. Both groups were compared in terms of renal impairment markers and needed for dialysis and early postoperative outcome.
 Results:  Renal impairment needs management by dialysis was developed in nine patients [30%] in the pump group [group I] and two patients [7.67%] in the off-pump group, with a significant difference. Group [I] showed a significant increase of transfused blood, blood urea nitrogen, serum creatinine, acute kidney injury [13 patients], reopening for bleeding, postoperative renal impairment, need for renal dialysis, total intensive care unit stay, and the total duration of hospital admission. However, it had a significant reduction in hemoglobin and creatinine clearance.
 Conclusion: Off-pump coronary revascularization offers a better kidney function preservation and has a decreased risk for kidney dysfunction in patients with renal impairment without dialysis compared with coronary revascularization with cardiopulmonary bypass.

DOI

10.21608/ijma.2020.43214.1173

Keywords

Coronary artery, on pump, Coronary revascularization, Renal insufficiency, dialysis

Authors

First Name

Khalid

Last Name

Abdelsamad

MiddleName

-

Affiliation

Department of Cardiothoracic Surgery, Faculty of Medicine, Banysuef University, Banysuef, Egypt

Email

kh.ragab.cts@gmail.com

City

Banysuef

Orcid

-

First Name

Mohamed Shaffik

Last Name

Hassan

MiddleName

-

Affiliation

Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University, Egypt

Email

msha20@hotmail.com

City

Cairo

Orcid

-

First Name

Mohamed Eldesouky

Last Name

Sharaa

MiddleName

-

Affiliation

Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University, Egypt

Email

mohamedsharaa1970@gmail.com

City

Cairo

Orcid

-

First Name

Ismail Nasr

Last Name

Elsokkary

MiddleName

-

Affiliation

Department of Cardiothoracic Surgery, Faculty of Medicine, Al-Azhar University, Egypt

Email

drismailnasr@yahoo.com

City

Cairo

Orcid

-

Volume

3

Article Issue

1

Related Issue

21557

Issue Date

2021-01-01

Receive Date

2020-09-17

Publish Date

2021-01-01

Page Start

976

Page End

983

Print ISSN

2636-4174

Online ISSN

2682-3780

Article File

IJMA_Volume 3_Issue 1_Pages 976-983.pdf

PDF . 1.1MB

Link

https://ijma.journals.ekb.eg/article_120303.html

Detail API

https://ijma.journals.ekb.eg/service?article_code=120303

Order

11

Type

Review Article

Type Code

817

Publication Type

Journal

Publication Title

International Journal of Medical Arts

Publication Link

https://ijma.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023