ABSTRACT 66

OFF-PUMP OR ON-PUMP CORONARY ARTERY BYPASS SURGERY:  WHICH IS BETTER FOR WOMEN?

Phillip Brown, Centennial Hospital, Nashville, TN;  Sal Battaglia, HCA Healthcare, Nashville, TN; Lynn Tarkington, HCA Healthcare, Nashville, TN; Steve Horner, HCA Healthcare, Nashville, TN; Edmund Becker, Emory University, Atlanta, GA; April Simon, Cardiac Data Solutions, Inc., Atlanta, GA

Purpose:    The purpose of this analysis, was to examine the results of CABG in women who underwent the procedure with and without the use of the cardiopulmonary bypass pump. 

Methods:  The HCA Casemix Database was utilized.  It includes 5,066 consecutive CABG surgeries performed on women in 72 hospitals in 1999.  Of these procedures, 885 were performed off-pump (OPCAB) and 4,181 were performed on-pump.  Mortality and eight complication rates were analyzed; cardiac, neuro, peripheral vascular, post-op infection, renal, respiratory, hemorrhage, and mechanical failure. 

Results:  The mortality rate was over a percentage point lower for OPCAB than for on-pump CABG surgery; 3.39% versus 4.54%, respectively.  Although four of eight (50%) of the complication rates were lower in OPCAB, the only statistically significant difference was in neurologic complications; OPCAB 0.90% versus on-pump 1.94%. 

Conclusion:  OPCAB appears to improve the clinical outcomes for women undergoing CABG surgery; however, only neurologic complications reached statistical significance.