Meta-analyses Comparing Off-Pump Coronary Artery Bypass Grafting with On-Pump: What Do We Expect

摘要

An analysis of reported studies was conducted to establish or not the superiority of off-pump approach. A comprehensive search of RCTs and meta-analyses comparing these two techniques was performed in literature. Outcomes such as operative mortality,MI,stroke,AF,30-day surgical-site infections, RF, length of hospital stay, angina recurrence,reintervention and crossover from off-pump to on-pump were evaluated. 146 RCTs and 14 metaanalyses were retrieved. Endpoints such as operative mortality, perioperative MI, stroke, reoperation for bleeding, RF, length of hospital stay, AF and surgical-site infection appeared to be lower for off-pump. Controversy about off-pump still exists as there are limitations about RCTs and metaanalyses comparing these techniques. The majority of patients in these trials were low to moderate-risk who underwent one or double vessel bypass. Much larger studies, with high-risk patients, multiple vessel disease, more events and follow up in 3 and 5 years, are required.