A Comparative Analysis of Short-Term Outcomes of Off Pump Coronary Artery Bypass Grafting Alone or Simultaneous Cerebral Revascularization: A Single-Center Retrospective Study.

OBJECTIVES

The impact of simultaneous coronary artery bypass grafting (CABG) with cerebral revascularization versus CABG alone on perioperative complications and short-term outcomes remains controversial in patients with simultaneous coronary and cerebrovascular disease. Our study was specifically designed to evaluate the effects of simultaneous cardio-cerebrovascular revascularization versus isolated off-pump CABG (OPCABG) in patients with severe carotid stenosis.

METHODS

This retrospective analysis included patients undergoing OPCABG between May 2023 and May 2025. Participants were divided into two groups based on simultaneous carotid revascularization status, including the combined cardio-cerebrovascular revascularization group (n = 57) and the isolated OPCABG control group (n = 60). The primary endpoints comprised 30-day mortality and all-cause mortality during follow-up. Cardiac, hepatic, and renal function biomarkers were monitored daily for three consecutive postoperative days. Kaplan-Meier analysis demonstrated the survival probability of patients undergoing different surgical procedures throughout the follow-up period.

RESULTS

Our study with a median follow-up of 11.5 months (IQR: 6.8-20.0 months) observed a lower short-term mortality rate of 5.3% (3/57) in the combined cardio-cerebrovascular revascularization group. Our results demonstrated no significant differences in 30-day mortality and all-cause mortality during follow-up between the combined cardio-cerebrovascular intervention and isolated OPCABG. No intergroup differences were observed in cardiac, hepatic, or renal function within the first three postoperative days. The combined surgical approach reduced hospitalization duration.

CONCLUSION

Our findings demonstrated comparable short-term outcomes between patients receiving simultaneous cardio-cerebrovascular revascularization and those undergoing isolated CABG. This simultaneous intervention represents a clinically meaningful advancement in managing systemic vasculopathy.