Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction

Maribel G. Gamoso, Barbara Phillips-Bute, Kevin P. Landolfo, Mark F. Newman, Mark Stafford-Smith

Research output: Contribution to journalArticle

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Abstract

Renal dysfunction is a serious complication after coronary bypass surgery with cardiopulmonary bypass (CABG). Because duration of cardiopulmonary bypass (CPB) is associated with renal outcome, it has been proposed that avoidance of CPB with off-pump coronary bypass (OP-CAB) may reduce perioperative renal insult. We therefore tested the hypothesis that OPCAB is associated with less postoperative renal dysfunction compared with CABG surgery. With IRB approval, we gathered data for 690 primary elective coronary bypass patients (OPCAB, 55; CABG, 635). Perioperative change in creatinine clearance (DCrCl) was calculated by using preoperative (CrPre) and peak postoperative (CrPost) serum creatinine values, and the Cockroft-Gault equation (DCrCl = CrPreCl - CrPostCl). Univariate and linear multivariate tests were used in this retrospective analysis; P < 0.05 was considered significant. Multivariate analysis did not identify OPCAB surgery as an independent predictor of DCrCl. However, previously reported associations of Pre-CrCl, age, and diabetes with DCrCl were confirmed. Power analysis demonstrated an 80% power to detect a 7.0 mL/min DCrCl difference between study groups. In this retrospective study, we could not confirm that OP-CAB significantly reduces perioperative renal dysfunction compared with CABG surgery. Our findings suggest that reduction of renal risk alone should not be an indication for OPCAB over CABG surgery.

Original languageEnglish (US)
Pages (from-to)1080-1084
Number of pages5
JournalAnesthesia and Analgesia
Volume91
Issue number5
StatePublished - 2000
Externally publishedYes

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Coronary Artery Bypass
Kidney
Cardiopulmonary Bypass
Creatinine
Research Ethics Committees
Risk Reduction Behavior
Multivariate Analysis
Retrospective Studies
Serum
Power (Psychology)

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Gamoso, M. G., Phillips-Bute, B., Landolfo, K. P., Newman, M. F., & Stafford-Smith, M. (2000). Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction. Anesthesia and Analgesia, 91(5), 1080-1084.

Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction. / Gamoso, Maribel G.; Phillips-Bute, Barbara; Landolfo, Kevin P.; Newman, Mark F.; Stafford-Smith, Mark.

In: Anesthesia and Analgesia, Vol. 91, No. 5, 2000, p. 1080-1084.

Research output: Contribution to journalArticle

Gamoso, MG, Phillips-Bute, B, Landolfo, KP, Newman, MF & Stafford-Smith, M 2000, 'Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction', Anesthesia and Analgesia, vol. 91, no. 5, pp. 1080-1084.
Gamoso MG, Phillips-Bute B, Landolfo KP, Newman MF, Stafford-Smith M. Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction. Anesthesia and Analgesia. 2000;91(5):1080-1084.
Gamoso, Maribel G. ; Phillips-Bute, Barbara ; Landolfo, Kevin P. ; Newman, Mark F. ; Stafford-Smith, Mark. / Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction. In: Anesthesia and Analgesia. 2000 ; Vol. 91, No. 5. pp. 1080-1084.
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