Date of Award

2026

Document Type

Capstone

Degree Name

Master of Science (MS)

Department

Physician Assistant Studies

Committee Chair

LaDonna Clark

Abstract

Introduction: Coronary artery disease in the United States had 680,981 deaths in 2023 alone with 400,000 CABG procedures being done. Coronary artery bypass grafting is a procedure in which coronary arteries occluded by fatty plaques are revascularized to restore blood flow to the myocardium. There are two effective options for this procedure, one being the on-pump approach, and the other being off-pump. Both methods carry risks, such as stoke and MI, as well as benefits, but the question of which carries the better outlook on mortality and complications is up for debate. The purpose of this paper is to study and determine which option truly has an edge of the other when it comes to decreased rates of mortality, stroke, and other perioperative complications.

Methods: PubMed was searched for clinical trials, meta-analyses, and studies using the terms “coronary artery bypass,” “off-pump,” and “outcomes” to determine if the on-pump CABG or off-pump carries the better prognosis. 15 resulted and 4 articles were selected for clinical review.

Results: The study resulted in two articles showing no significant statistical difference between the two options with an OR of 0.876, while the other two stated that the off-pump approach carried the better prognosis. Patient comorbidities and age were noted in each of the four studies while one study found significantly higher rates of MI, without regard to type of CABG in the 51-60 year-old age group. Adverse complications were more common in the short-term (less than 90 days) when looking at the on-pump procedure, but the risk for complication from mid- to late-term (3 months and beyond) was relatively the same for both surgical methods.

Conclusion: Off-pump coronary artery bypass showed statistical evidence for being the more efficacious of the two procedures. Further research is needed to determine the better of the two methods with a larger sample size and studies that follow patients over a longer period of time.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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