Comparison of On-Pump Beating Heart Surgery Versus Conventional Bypass Surgery in Patients with Acute Myocardial Infarction Requiring Urgent Revascularization

Background: The objective of our study was to provide the

initial outcomes of the traditional coronary artery surgery

approach and the on-pump beating heart surgery in terms

of survival and morbidity in patients who needed emergency

surgery for acute myocardial infarction. Methods:

A single-center retrospective study was performed from

November 2013 to September 2023 on a total of 212 patients

requiring emergency coronary artery surgery. Group

I patients (n = 108) received traditional coronary artery

bypass grafting with cross-clamping, while Group II patients

(n = 104) underwent on-pump coronary surgery on

the beating heart. Results: There were no disparities observed

in the preoperative left ventricular function, percutaneous

coronary intervention, intra-aortic balloon usage, or

clinical-hemodynamic characteristics. Group I patients had

significantly higher rates of postoperative mortality and low

cardiac output syndrome, as well as a greater utilization of

intra-aortic balloons and a higher requirement for extracorporeal

membrane oxygenation (p < 0.001). Conclusions:

Ultimately, the on-pump beating heart approach could serve

as a viable alternative to enhance the preservation of cardiac

function and decrease postoperative complications and

mortality rates in patients with acute myocardial infarction

who require emergency surgery.