Outcomes of the OFF pump to ON pump converted Patient depends on Timing of Conversion

Volume : VII, Issue : VIII, August - 2018

Dr. Mariappan Balaiah, Dr. Gnanavelu Ganesan, Dr. Prem Ananth

OFF–Pump CABG has less perioperetive morbidity and mortality then ON–Pump CABG. Some patients need to convert OFF pump

to ON pump. Emergency conversion ON pump increase the operative morbidity and mortality.

We are analyzing the determinant of conversion, Predicting factors, Impact of timing on the outcome of convertion.

Methods: In this study, we conducted retrospective know of 311 consecutive patients who were planned for OFF pump CABG

from Feuary 2013 to January 2018. This review included the preoperative characteristics operative and Post operative outcomes

as well as the timing of conversion either before Hemodynamic collapse or after the Hemodynamic collapse.

Results: Out of 311 patients planned for OFF pump, 11 patients need conversion to ON pump (Incidence – 3.53%) out of those 11

patients 4 patients converted to ON pump before Hemodynamic collapse 7 patients after Hemodynamic collapse. Analysis of

Preoperative characteristics showed that presence of moderate mitral regurgitation, COPD, LV EF < 35% are the rise factors for

the conversion of OFF pump CABG to ON pump CABG, operative mortality was 27.27% in conversion group and 4% in nonconversion

group. Mortality is High (100%) in delayed Conversion group than early conversion group (0%).

Respiratory failure, use of IABP, and ICU stay were significantly higher in conversion group than Non–conversion group. They were

(27.27% Vs – 0.66%), (18.18% Vs– 0.66%) and (12.5 ± 3.8 Vs 10.4 ± 2.3) respectively.

Conclusion: Patients who are in needed of OFF pump CABG require conversion to ON pump have lesser morbidity and mortality

than ON pump. Time of conversion plays an important role in the outcome.

We concluded delayed conversion is associated in the very poor outcome. However early conversion, especially before

hemodynamic collapse have better outcome.

Based on this, before planning for OFF pump, analysis all the risk factors for conversion to ON pump and the patient to be

thoroughly monitored and conversion before Hemodynamic collapse.