Effects of on-pump and off-pump surgery in the Arterial Revascularization Trial

This descriptive study presents the peri-operative and 1-year results of on-pump and off-pump surgery performed in patients enrolled in the Arterial Revascularization Trial (ART). Out of the 3102 patients randomised in the ART trial to undergo either single or bilateral mammary artery grafting, 41% had their surgery performed off-pump. The decision to perform on or off-pump surgery was at the discretion of the surgeon. A similar number of grafts were performed in off-pump and on-pump procedures. Both operative time and ventilation time were shorter in patients who had off-pump surgery. Blood loss and platelet transfusion requirements were also lower in the off-pump surgery group. There was no clinically significant difference in 30-day mortality, stroke, peri-operative myocardial infarction, need for repeat revascularization or 1-year mortality between the off-pump and on-pump groups (formal statistical hypothesis testing was not performed due to the study design).