Comparative Studies On The Coronary Heart Disease Underwent Coronary Artery Bypass Grafting On-pump And Off-pump Bypass

In this study, we analyze the influences between OPCAB and CCABG to some of subsystems, and postoperative rehabilitation. We also analyze the clinical significance, in order to provide better program for treatment and theoretical evidents.Objective: The purpose of this study was to compare the renal function, respiratory function, nervous function and the postoperative recovery of coronary artery bypass grafting (CCABG)operationg with and without pulmonary bypassurgical therapys, evaluate the two methods in surgical therapy of coronary artery disease.Methods: A total of 230 patients underwent CABG in cardiac surgery department of the second hospital of Jilin University between May 2003 and December 2008, one group performed CCABG with CPB and the other group without CPB (OPCAB). The value of CREA and BUN between preoperative and postoperative, postoperative mechanic ventilation time, equal ICU time, length of stay after operation, drainage of the first day, quantity of the blood transfusion in perioperative, operative time, cost, vascular anastomosis, and correlative complication are compared.Result: The two groups did not differ with respect to preoperative data, besides age, sex and EF. The two groups have the same number of anastomosis (3.0±1.0VS3.0±1.0 P > 0.05) in CABG. In the CCABG group, the mechanic ventilation time (18.25±20VS15±8.5 P<0.05) and ICU time(5±2.4VS3.0±2.0 P<0.05) is significant higher than OPCAB group, the postoperative time in hospital(16±10VS11.5±6)and the operative time(5.0±1.3VS4.0±1.0) is significant higher than OPCAB group, and also the cost(645405±3108VS60124±1306) is higher than OPCAB group with significant too. There is no significant difference between the two groups in quantity of red cell suspension ( 800±400VS800±50 P > 0.05 ) and blood plasma (800±500VS800±300) in perioperative time. Kidney and creatinine do not change along with time and group. The urea nitrogen does not change along with time, but the CCGAB group is significant higher than OPCAB group.The complications(atrial fibrilation) and the rate of death is no significant difference after operation.Conclusion: The present study demonstrated that OPCAB is a safer and feasible, to be worth spread. OPCAB demand high technique and has superiority in gerontal patient, high risk patient and low EF patient. It can cut down the death rate of high risk group significantly. Further more, it reduces ICU time, length of stay, the cost and also decrease the pressure of nursing care. We retrospective analyses in this text that OPCAB has advantages in some directions than CCABG; the two methods still need general comparison and long-term follow-up visit, however. Which is better remains to be observed. Moreover, OPCAB has significant predominance in the three important vascular lesion, ophthalmic needle ventricular aneurysm formation appear left artrium throm, left artrium multiplication and the heart difficult to shift.