Comparison of on-pump versus off-pump coronary artery bypass surgery in diabetic patients
1Nasir Islam, 2Imran Khan Khalil, 3Dr Sajid Khan, 4Aitizaz Ahsan
1Consultant cardiac surgeon, Fauji foundation hospital Peshawar,
2Consultant cardiac surgeon, MMC General Hospital Peshawar
3Consultan mti hmc peshawar
4Registrar Cardiac Surgery
Vol: 05, Issue 03, 101-110
Received: August 25, 2025 Accepted: January 02, 2026, Published: January 20, 2026
ABSTRACT:
Background: The coronary artery disease was very common among diabetic patients and was also a contributor to the higher morbidity and mortality rates after the coronary artery bypass grafting (CABG). Abreast surgery to this at-risk group was controversial as to the best surgical method. On-pump CABG which was done using cardiopulmonary bypass was historically believed to be the optimal modality but off-pump CABG continued to be more popular as a method of reduction of systemic inflammatory response, metabolic derangements and end-organ complications especially in diabetic patients who were prone to the negative effects in a more pronounced manner.
Aim: This study was meant to compare the perioperative and the early postoperative results of on-pump and off-pump coronary artery bypass surgery in diabetic patients.
Methods: The comparative study was done in Shifa International Hospital Islamabad, between November 2024 and October 2025. One hundred and ten diabetic patients who had undergone isolated CABG were enlisted in the research. The patients were split into two categories, depending on the method of surgery performed: on-pump CABG group and off-pump CABG group. Demographic information, comorbidity, and operation characteristics were taken at baseline. Outcomes measured in the postoperative period were duration of mechanical ventilation, length of stay in the intensive care unit (ICU), total length stay, occurrence of postoperative complications which included; atrial fibrillation, wound infection, renal dysfunction and in-hospital mortality. Proper statistical tools were used to conduct data analysis with an aim of comparing the results of the two groups.
Results: The off- pump CABG group had a much short mechanical ventilation and less ICU/ hospital stay than the on-pump group. The incidence of postoperative complications such as atrial fibrillation, kidney dysfunction and infection on the surgical site was lower among patients who had off-pump CABG. In-hospital mortality also showed a decrease in the off-pump; this was not statistically significant. Comprehensively, off-pump CABG was linked to lower economic postoperative results in diabetic patients.
Conclusion: Off-pump coronary artery surgery was found to have lower postoperative morbidity and recognition of a shorter recovery time than on-pump CABG did with diabetic patients. They were pointing towards the belief that off-pump CABG was a safe and efficient alternative to the standard on-pump method in this high-risk group, especially in those areas that minimize early postoperative complications.
Keywords: Coronary artery bypass grafting, On-pump CABG, Off-pump CABG, Diabetes mellitus, Postoperative outcomes.