Use and Outcomes of Intra-Aortic Balloon Pump in Conventional Vs Off Pump Coronary Artery Graft Surgery: A Comparative Study

Objective: To compare the usage and outcomes of IABP undergoing conventional on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCAB) patients. Study Design: Comparative Cross-sectional study. Place and Duration of Study: Adult Cardiac Surgery Unit, Tertiary Care Cardiac Center, Rawalpindi Pakistan, from Nov 2022 to Feb 2023. Methodology: The study population comprised patients experiencing isolated coronary artery bypass grafting surgery irrespective of age and gender through non-probability consecutive sampling. CABG procedures with another concomitant procedure and conversion from OPCAB to on-pump CABG were excluded. Data entered and analyzed in SPSS v-24. Descriptive statistics were calculated and comparison between variables was made by chi-square test and independent sample t-test. Results: 328 patients were recruited during the study duration. Out of 328, 207(63.1%) had on-pump CABG while 121(36.9%) had off-pump CABG (OPCAB). Most of the study population were males 276(84.1%), whilst 52(15.9%) were females. 202(61.6%) of the patients were hypertensive, 159(48.5%) were diabetics, 38(11.6%) were smokers and 32(9.7%) patients had intra-aortic balloon pump (IABP) insertion. Comparison between IABP usage and outcome variables was significant with CPB time (p=0.031), ICU stay (p<0.001), hospital stay (p=0.004), priority status of the surgery (p<0.001), ejection fraction (p=0.008) and mortality (p<0.001). Conclusion: Overall, IABP remains a valuable support tool in managing high risk CABG patients.