On-pump coronary artery bypass grafting and off-pump on beating heart coronary artery bypass grafting surgical techniques' effects of the comparisons of kidney and liver function tests

Side effects and risks of cardiopulmonary bypass (CPB), as well as advances in technical equipment, have led to an increased interest in the coronary artery baypas grafting (CABG) surgical technique in the non-pumped heart. Two of the organs in which cardiopulmonary bypass shows side effects are kidney and liver. The aim of our study was to compare the effects of pump CABG and non-pumped heart CABG surgical techniques on renal and liver function tests. In this study, the files, perfusion forms and computerized data of 80 patients who underwent elective isolated coronary artery bypass surgery between January 1, 2011 and January 31, 2017 in the cardiovascular surgery clinic of Dokuz Eylul University Hospital were evaluated retrospectively. Statistical evaluation of preoperative, postoperative 24th and 48th hour intervals of BUN, CREATIN, AST, ALT, AST / ALT ratio, which are important tests, were performed to evaluate renal and liver functions of patients. Patients were divided into 40 patients with pump CABG surgery (Group 1) and 40 patients without pump CABG surgery (Group 2). Of the 80 patients selected according to the criteria of the study, 26 were female and 54 were male. There was no statistically significant difference between groups in terms of gender, age, height, weight, body mass index and EF ratios. There was a statistically significant difference in the number of bypass grafts performed between groups. This difference was found to be higher in Group 1. There was no statistically significant difference between the groups in terms of chronic diseases, diabetes mellitus, hypertension, hyperlipidemia and Chronic Obstructive Lung Disease. However, a significant difference was observed in DM and the number of diabetic patients was higher in Group 2. There was no statistically significant difference in BUN values between the groups in all three time periods. There was no statistically significant difference in creatinine values between the three groups. In Group 1, preoperative creatinine value increased at postoperative 24th and 48th hours, whereas there was no significant difference between time and creatinine values in Group 2. In the inter-group AST evaluation, the AST value of Group 1 was found to be statistically higher than Group 2 at the 24th and 48th hours of preoperative and postoperative period. In the inter-group ALT evaluation, the postoperative 24th hour ALT value was significantly higher in Group 1 than in Group 2. no statistically significant difference was observed in the preop and postop 48th hours. There was a significant difference in AST / ALT intergroup evaluations in preop, postop 24th and 48th hour data. Group 1 values were found to be higher in these time intervals. Our results suggest that CABG surgical technique is more advantageous in non-pumped heart in terms of protection of renal function. This supports our hypothesis. Keywords: coronary artery, cardiopulmonary bypass, working heart, kidney, liver.