MEDIASTINAL BLEEDING AND BLOOD TRANSFUSIONS IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY PERFORMED WITH OR WITHOUT CRDIOPULMONARY BYPASS
Keywords:Blood transfusion, Coronary artery bypass grafting, Cardiopulmonary bypass, Off-pump coronary artery bypass, On-pump coronary artery grafting, Red cell concentrate
Objective: To determine the rate of postoperative bleeding and blood transfusions in patient undergoing coronary artery bypass surgery for coronary artery disease during OPCAB or conventional CABG.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Adult Cardiac Surgery Departments of Armed Forces Institute of Cardiology & National Institute of Heart Disease (AFIC/NIHD) Rawalpindi, Pakistan from 1 July 2017 to 31 Dec 2017.
Material and Methods: Two hundred patients undergoing coronary artery bypass surgeries performed with (Conventional CABG) or without cardiopulmonary bypass. (Off pump CABG /OPCAB) were enrolled in the study and were divided into two equal groups. All procedures were elective. Careful monitoring was carried out on hourly basis. The rate of postoperative chest drainage and number of blood transfusions received were measured in both groups.
Results: As compared to the OPCAB group, the patients in CPB group required ion tropic support for a longer duration (29.6 ± 65.1 vs 60.9 ± 71.2, p-value <0.02). Similarly, the rate of chest drainage was significantly higher in conventional CABG Vs OPCAB (45% vs 30% p<0.026). Requirement of blood transfusion (RCC) was significantly higher in conventional CPB vs OPCAB group (1.6 ± 1.6 vs 1.0 ± 1.2, p-value 0.04). Mechanical ventilation time was almost same in both groups with median value of 6 hours.
Conclusions: Our study concluded that the main advantages of OPCAB technique are that there is less amount of postoperative chest drainage and it makes it possible to decrease the number of blood transfusions after surgery.