Comparison of medical and economical effectiveness of off-pump and on-pump coronary artery bypass grafting in elderly patients
Aim. The purpose of the study was to determine which method of coronary artery bypass grafting is more effective for old patients on comparison of medical and economic effectiveness. Material and methods. Retrospective analysis was performed on patients have underwent coronary artery bypass grafting since April 2009 till June 2011. Patients were divided in two groups. In to the first group were included patients operated off-pump and into the second group were included patients operated on-pump. In each group number of patients was 79. All patients have been selected on following criteria: age >60 years, isolated coronary artery bypass grafting, operation was performed by one of the authors of investigation. Results. Complications after the off-pump revascularization were registered in 4 (5.1%) cases and in 11 (13.9%) cases operated on-pump. Comparative analysis showed incidence of complications to be higher in group operated on-pump than off-pump (p <0.01). One (1.3%) patient died after off-pump CABG and four (5.1%) patients died which have underwent myocardial revascularization on-pump. Financial analysis showed that average cost of CABG on-pump was 295 598,31 rub., and cost of CABG off-pump was 173 375,96 rub. (p< 0.001). On the base of previous publications and our results we may conclude that medical and financial effectiveness to be higher in patients operated off-pump. Conclusion. Medical and economic effectiveness are higher in old patients operated off-pump.