Off-pump CABG showed similar wound complications but fewer transfusions and shorter stays versus on-pump CABG in 394 patients.

This single-center retrospective cohort study included 394 patients who underwent isolated coronary artery bypass grafting with available pre- and postoperative coronary angiography. The analysis utilized propensity score matching to create 157 matched pairs comparing off-pump coronary artery bypass grafting (OPCAB) against conventional on-pump coronary artery bypass grafting (CABG). The primary outcome assessed leg wound complications, while secondary outcomes included early graft occlusion, saphenous vein graft stenosis, reintervention, perioperative outcomes, and major adverse cardiac and cerebrovascular events (MACCE). Follow-up extended up to 10 years.

Regarding wound healing, leg wound complications occurred in 1.3% of the OPCAB group versus 0.6% in the on-pump group, with a p-value of 1.00 indicating no significant difference. Early graft occlusion rates were 9.6% for OPCAB and 10.3% for on-pump CABG (p = 0.553). Saphenous vein graft occlusion occurred in 5.7% of OPCAB patients compared to 4.5% in the on-pump group (p = 0.798). Thirty-day mortality was 12.1% in both groups, and 12-month MACCE rates were also identical at 12.1%.

Resource utilization favored the off-pump approach. Red blood cell transfusions were fewer in the OPCAB group at 49.7% versus 64.3% in the on-pump group (p = 0.012). Operative time, intensive care unit stay, and hospital stay were all shorter in the OPCAB group, though specific duration values were not reported. No significant differences were found for long-term MACCE-free survival.

The study was limited to a single-center setting. Funding or conflicts of interest were not reported. While OPCAB improved perioperative resource utilization, it did not reduce GSV harvest-site complications compared with on-pump CABG. These findings are derived from an observational design and associations should be interpreted with caution regarding causality.