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Objective:To compare the clinical effects of on-pump and off pump coronary artery by pass grafting in elderly patients.METHODS:of 60 patients(≥70years ),21 underwent conventional pump coronary artery bypass grafting(CCABG) and 39 off pump coronary artery bypass grafting(OPCAB).oxygenation index(OI), creatinine and left ventricular eject fraction(LVEF)were detected before and after operation.Operation time,24 hours urine,blood vessel active medicine usage,ICU time, postoperative hospital stay,endotracheal intubation time,vessel bridge count, postoperative drainage,blood transfusion volume are also be recorded.RESULT The mortality were 23.81%in CCABG group and 2.56%in OPCAB.Major postoperative complications were 37.50%in CCABG group and 7.89%in OPCAB.When the value of LVEF＞45%,postoperatively LVEF were improved in both groups(P＜0.05),but no significant difference between two groups(P＞0.05);when LVEF≤45%, postoperatively LVEF were improved in both groups(P＜0.05) too,improved significantly in OPCAB group than CCABG group(P＜0.05).Preoperatively OI in OPCAB group is lower than the CCABG group(P＜0.05);after operation,OI decreased significantly in both Groups(P＜0.05),but no significant difference between two groups (P＞0.05).Postoperatively Cr were increased significantly in CCABG group than OPCAB group(P＜0.05).Operation time were shorter in OPCAB group than CCABG group(P＜0.05).24 hours urine of CCABG group were more than OPCAB group(P＜0.05).Blood vessel active medicine usage,ICU time,postoperative hospital stay, postoperative drainage have no significant difference in both groups(P＞0.05). Intubation time were shorter in OPCAB group than CCABG group(P＜0.05).Vessel bridge counts in CCABG group were more than OPCAB group(P＜0.05).Blood transfusion volume,OPCAB group were less than CCABG group(P＜0.05). CONCLUSION.OPCAB has less affect on heart function and lung function and renal function compared with CCABG.Therefore,OPCAB more conducive to elderly patients compared with CCABG.
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