Off-pump Coronary Surgery Research Articles

Neurological Complications of On-Pump versus Off-Pump Coronary Artery Bypass Graft Surgery

Neurological Complications of On-Pump versus Off-Pump Coronary Artery Bypass Graft Surgery

Invited Commentary

Invited Commentary

Myocardial protective effect of dexmedetomidine on patients undergoing off-pump coronary artery bypass grafting

Objective To observe myocardial protective effect of dexmedetomidine (Dex) on patients undergoing off-pump coronary artery bypass grafting. Methods Fifty-seven patients scheduled for off-pump coronary artery bypass grafting surgery were selected, the gender was not restricted, aged 43-74 years and American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ). All patients had no history of acute myocardial infarction, heart failure, cardiac surgery, and obvious dysfunction of liver, kidney and lung. Enrolled patienrs were randomly divided into control group and Dex using computer random software. In Dex group, Dex was given as a bolus of 1 μg/kg over 10 min followed by an infusion of 0.5 μg/(kg·h) throughout the surgery before induction of anesthesia, and the equal volume of normal saline was given in control group. Artery systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded after entering the operating room (T0), after loading dose injection (T1), before anesthesia induction (T2), immediately after endotracheal intubation (T3), after the vascular anastomosis (T4), and immediately at the end of surgery (T5). Blood samples were collected from the central vein for detection of high-sensiti cardiac troponin T (hs-cTnT) concentration after entering the operating room (T0), 3 h (T6) and 24 h (T7) after surgery. The operation time, intensive care unit (ICU) stay time, the incidence of arrhythmia and myocardial infarction, and mortality within 14 days postoperation were recorded. Results The levels of SBP in the Dex group [(127.70±10.40), (121.60±7.33) and (121.30±7.24) mmHg (1 mmHg=0.133 kPa)] were decreased significantly as compared with the control group [(139.00±13.09), (137.20±10.50) and (142.00±9.00) mmHg] at T3, T4 and T5 (P=0.000). The levels of DBP in the Dex group [(82.43±8.79) and (82.87±6.61) mmHg] were decreased significantly as compared with the control group [(96.93±10.17) and (101.3±9.89) mmHg] at T4 and T5 (P=0.000). The levels of HR in the Dex group [(67.97±5.08), (66.93±4.76), (68.43±4.47) and (66.53±4.59)/min] were lower than in the control group [(77.33±7.28), (77.87±8.25), (77.40±7.40) and (75.43±7.27)/min] from T2 to T5 (P=0.000). The levels of hs-cTnT concentration in the Dex group [(124.3±55.8) and (101.3±41.8) ng/L] were relatively decreased as compared with the control group [(152.2±52.5) and (122.5±47.6) ng/L], but no significant difference was found at T6 and T7 (P=0.057, 0.079). Conclusion The continuous infusion of Dex can maintain hemodynamic stability, mitigate myocardial ischemia-reperfusion injury and protect the myocardial cells in the patients undergoing off-pump coronary artery bypass grafting surgery. Key words: Dexmedetomidine; Coronary artery bypass grafting; Myocardial ischemia; Reperfusion injury; Myocardial preservation

A comparison of clinical outcomes of LVEF ≤35% versus LVEF>35% in off-pump coronary artery bypass graft surgery

Background: Management of patients with coronary artery disease (CAD) and low ejection fraction (EF) is challenging. The objective was to compare the effect of low EF to normal EF on clinical outcomes after off-pump coronary artery bypass graft (OPCABG) surgery.Methods: All patients who underwent CABG at VMMC and Safdarjung hospital, from June 2014 till December 2016 with LVEF≤35% (low EF) as well as LVEF>35% (high EF) were studied and their surgical results analyzed by collecting data retrospectively. Out of 203 total patients the LVEF was less than or equal to 35% in 41 (20.19 %) patients, more than 35% in162 (79.81 %) patients.Results: In LVEF≤35% there were 9 females and the mean age was 60.39±8.76 years, The mean ICU stay in hospital was of 8.73 days, mean ventilator support was 4.01 days, ionotropic support was 4.34 days, mean stay in hospital was of 28.54 days, hospital mortality was 8 (19.51%) in LVEF≤35 versus mean ICU stay in hospital was of 8.73 days, ventilator support was 4.01 days, ionotropic support 4.34 days, mean stay in hospital was of 20.33 days, hospital mortality was 13 (8.02%) in LVEF>35.These data make a survival rate of 80.49% for EF in LVEF≤35 versus 91.98% for EF in LVEF>35.Conclusions: CABG can be safely performed in low-EF patients with minimal postoperative morbidity and mortality in addition to encouraging home discharge rates.

Pathway-related modules involved in the application of sevoflurane or propofol in off-pump coronary artery bypass graft surgery.

Off-pump coronary artery bypass graft (CABG) surgery has recently emerged as a means to avoid the sequelae of extracorporeal circulation, including the whole-body inflammatory response, coagulation disorders and multiple organ dysfunction. At present, gas anesthesia, sevoflurane and intravenous anesthesia and propofol have been widely used during the CABG. To further understand the underlying mechanisms of these anesthetics on the gene level, the present study conducted pathway-related module analysis based on a co-expression network. This was performed in order to identify significant pathways in coronary artery disease patients who had undergone off-pump CABG surgery before and after applying sevoflurane or propofol. A total of 269 and 129 differentially expressed genes were obtained in the sevoflurane and propofol groups, respectively. In total, eight and seven pathways (P<0.05) in the sevoflurane and propofol groups were separately obtained via Kyoto Encyclopedia of Genes and Genome pathway analysis. Finally, eight and seven pathway-related modules in the sevoflurane and propofol groups were obtained, respectively. Furthermore, the mean degree of complement and coagulation cascades pathway-related module in both of the groups was the highest. It was predicted that during the CABG, the anesthetics might activate the complement and coagulation systems in order to possess some cardioprotective properties.

Long-term survival after off-pump versus on-pump coronary artery bypass graft surgery. Does completeness of revascularization play a role?

BackgroundWe sought to compare the incidence of incomplete revascularization (IR) and long-term survival (up to 20years) after off-pump (OPCAB) versus on-pump (ONCAB) coronary artery bypass in a high OPCAB volume centre where OPCAB was introduced in 1996 and has become the preferred strategy over the years. Methods and resultsFrom 1996 to 2015 a total of 7,427 OPCAB and 7128 ONCAB procedures were performed at Bristol Heart Institute, United Kingdom. We obtained 5423 propensity matched pairs for final comparison. Mixed effect Cox model accounting for clustering due to different surgeon was used to investigate the treatment effect on mortality. ResultsOPCAB was associated with higher rate of incomplete revascularization 13.3% versus 6.7%; P<0.0001). Mean follow-up time was 7.8±4.6year [max 17.3]. At 12years OPCAB was associated with a marginal but significant +3% increase in overall mortality (67.4%[95%CI 65.8–69.1] vs 64.4%[95%CI 62.7–66.2]; stratified log-rank P=0.03). When compared to ONCAB with complete revascularization, OPCAB with IR (HR 1.74;95%CI 1.53–1.99; P<0.001) and ONCAB with IR (HR 1.29; 95%CI 1.06–1.57; P=0.01) but not OPCAB with complete revascularization (HR 1.02;95%CI 0.94–1.11; P=0.63) were associated with increased risk of late mortality. ConclusionDespite completeness of revascularization was achieved in the majority of OPCAB cases, OPCAB remained associated with a significantly higher rate of incomplete revascularization. This translated into a marginal but significant reduction in late survival rates after OPCAB when compared to ONCAB.

Early Post operative Pain Management and Early Extubation after Off-pump Coronary Artery Bypass Graft Surgery is better managed with Thoracic Epidural Analgesia

Background: Off-pump coronary artery bypass (OPCAB) graft surgery is the commonest operation worldwide. Sternotomy, pleurotomy with opening of the pleural space, harvesting of internal mammary artery may lead to severe post-operative pain. Thoracic epidural analgesia (TEA) may reduced significant post-operative pain &amp; allow the patient early extubation.Methods: A total of 60 patients with ischaemic heart disease (IHD) were included in the study who were admitted in the Department of Cardiac Surgery in NICVD, Dhaka from July 2006 to June 2008 &amp; underwent off-pump coronary artery bypass (OPCAB) graft surgery. Out of the total 60 patients, 30 were in the group-A receiving thoracic epidural analgesia along with general anaesthesia and the rest 30 were in the group-B receiving general anaesthesia alone.Results: Patients in the epidural group had significantly less pain on the operative day and for the next 2 days. Total ventilation time in hours in Group-A was 6.4 + 1.0 and in Group-B was 10.1 +1.8 hours respectively. Postoperative X-ray chest revealed significant pulmonary complication in Group- B than Group-A. There were no complications related to epidural haematoma and no permanent neurological squeal.Conclusion: Thoracic epidural analgesia reduced significant post-operative pain and improvement in pulmonary function and early extubation.Cardiovasc. j. 2017; 9(2): 142-146

Transesophageal Echocardiographic Assessment of Pulmonary Artery-to-Ascending Aorta Ratio for the Detection of Pulmonary Hypertension in Cardiac Surgical Patients

The objective of the study was to investigate if the main pulmonary artery (mPA)-to-ascending aorta (AscAo), (mPA:AscAo) ratio could serve as a screening tool in identifying pulmonary artery hypertension (PAH). A prospective observational study. Tertiary care center, university hospital. Fifty-four adult patients undergoing off-pump coronary artery bypass grafting surgery (OPCAB). mPA and AscAo transverse diameters were measured by transesophageal echocardiography (TEE) and the mean pulmonary arterial pressures (mPAP) were recorded simultaneously using a pulmonary artery catheter. mPA:AscAo ratio demonstrated significant linear correlation with mPAP measured by pulmonary artery catheterization (ie, r = 0.61, confidence interval [CI] = 0.5352-0.6736, p < 0.0001). Receiver operating characteristic curves were performed to evaluate sensitivity and specificity of mPA:AscAo ratio ≥1 for diagnosing PAH (mPAP ≥25 mmHg). Area under the curve for mPA:AscAo ratio was 0.91 (95% CI, 0.869-0.936, p < 0.0001), with a sensitivity of 84.27%, specificity of 83.92%, positive-predictive value of 87.6% and negative-predictive value of 81.1% for a mPAP ≥25 mmHg. The ratio of mPA:AscAo is a simple, reliable, and reproducible method that can be obtained through TEE, which guides the clinician to screen patients with PAH.

B-Type Natriuretic Peptide and Hemoglobin are Two Major Factors Significantly Associated With Baseline Cerebral Oxygen Saturation Measured Using the INVOS Oximeter in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

To investigate an association between the preoperative plasma B-type natriuretic peptide (BNP) concentration and cerebral regional saturation (rSO2) measured using the INVOS oximeter (Medtronic, Minneapolis, MN). A retrospective data analysis. Single university hospital. Patients undergoing off-pump coronary artery bypass (OPCAB) surgery. None. Associations of variables obtained from preoperative blood laboratory tests and transthoracic echocardiography with baseline rSO2 before induction of general anesthesia were investigated using bivariate and multivariate regression analyses in 330 OPCAB patients. With bivariate analyses, age; body size-related variables such as weight and body surface area; hematologic function-related variables such as blood hemoglobin (Hb) concentration and arterial oxygen saturation; renal function-related variables including estimated glomerular filtration rate, creatinine, and blood urea nitrogen; hepatic function-related variables including cholinesterase, albumin, total bilirubin, and alanine aminotransferase; serum electrolytes including sodium, chloride, and phosphorus; BNP or log-transformed BNP; and 13 transthoracic echocardiography variables such as left ventricular ejection fraction highly significantly correlated with baseline rSO2 (p < 0.0001). However, the multiple regression analysis revealed that only BNP and Hb remained major factors significantly associated with baseline rSO2 (p < 0.0001), while estimated glomerular filtration rate, arterial oxygen saturation, and body surface area remained minor factors (p < 0.05). Baseline rSO2 correlated better with log-transformed BNP than with BNP, indicating that rSO2 correlated with BNP in an exponential fashion. Preoperative BNP and Hb concentrations were 2 major factors associated with INVOS rSO2 in patients undergoing OPCAB.

The effect of desflurane on hemodynamics and myocardial protection in patients undergoing off-pump coronary artery bypass grafting surgery

Objective To evaluate the effect of desflurane on hemodynamics and myocardial protection in patients undergoing off-pump coronary artery bypass grafting surgery (OPCABG). Methods Fifty patients, scheduled for OPCABG, were randomly assigned to two groups: the desflurane group (D group, n=25) and the propofol group (P group, n=25). For all patients, 10 mg morphine and 3-5 mg midazolam were intramuscularly injected before anesthesia. 0.1-0.2 mg/kg etomidate was used for anesthesia induction followed by rocuronium 0.6 mg/kg and sufentanil 1-2 μg/kg for all patients. For all patients, sufentanil 0.5-1.0 μg/(kg·h) and Cisatr-curium 0.5- 1.0 mg/(kg·h) were maintained. Desflurane 0.7-1.5 MAC was maintained in D group. Propofol 2-8 mg/kg was maintained in P group. Manometry was conducted through puncture in radial artery and right internal jugular vein for all patiens. The changes in cardiac index (CI), heart rate (HR), blood pressure (ABP), right atrial pressure (CVP), pulmonary arterial pressure (PAP) and pulmonary artery wedge pressure (PAWP) were monitored perioperatively. Bispectral index (BIS) was maintained at 40- 60. Temperature and urine were monitorred routinely. Before and 6, 12, 24 and 36 h after operation, blood samples were collected to measure troponin Ⅰ (cTnⅠ) and creatine kinase isoenzyme (CK-MB). Results Plasma cTnⅠ and CK-MB levels in postoperative period were higher than the preoperative baseline in both groups. cTnⅠ and CK-MB level were significantly higher in P group than in D group [(0.77±0.38) vs. (0.96±0.42), P=0.034; (23.79±5.96) vs. (28.13±7.51), P=0.042]. Conclusion Our results suggest that desflurane combined sufentanil anesthesia provides better management of reduced myocardial injury and less intropic agents usage in OPCABG. Key words: Desflurane; Off-pump coronary artery bypass; Hemodynamic; Myocardial protection

20 Years of Off-Pump Coronary Bypass Surgery in Clinical Routine: An Evolution with Contribution by the Leipzig Heart Center.

20 Years of Off-Pump Coronary Bypass Surgery in Clinical Routine: An Evolution with Contribution by the Leipzig Heart Center.

Sudden Hemodynamic Instability During Off-Pump Coronary Artery Bypass Grafting Surgery: Role of Bezold-Jarisch Reflex

Sudden Hemodynamic Instability During Off-Pump Coronary Artery Bypass Grafting Surgery: Role of Bezold-Jarisch Reflex

Automated Weaning from Mechanical Ventilation after Off-Pump Coronary Artery Bypass Grafting.

The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB. The secondary endpoint was to assess safety of the automated weaning mode and the number of manual interventions to the ventilator settings during the weaning process in comparison with the protocolized weaning mode. Forty adult patients undergoing elective OPCAB were enrolled into a prospective single-center study. Patients were randomized into two groups: automated weaning (n = 20) using INTELLiVENT-ASV mode with quick-wean option; and protocolized weaning (n = 20), using conventional synchronized intermittent mandatory ventilation (SIMV) + pressure support (PS) mode. We assessed the duration of postoperative ventilation, incidence and duration of unacceptable RS, and the load on medical staff. We also performed the retrospective analysis of 102 patients (standard weaning) who were weaned from ventilator with SIMV + PS mode based on physician's experience without prearranged algorithm. Realization of the automated weaning protocol required change in respiratory settings in 2 patients vs. 7 (5-9) adjustments per patient in the protocolized weaning group. Both incidence and duration of unacceptable RS were reduced significantly by means of the automated weaning approach. The FiO2 during spontaneous breathing trials was significantly lower in the automated weaning group: 30 (30-35) vs. 40 (40-45) % in the protocolized weaning group (p < 0.01). The average time until tracheal extubation did not differ in the automated weaning and the protocolized weaning groups: 193 (115-309) and 197 (158-253) min, respectively, but increased to 290 (210-411) min in the standard weaning group. The automated weaning system after off-pump coronary surgery might provide postoperative ventilation in a more protective way, reduces the workload on medical staff, and does not prolong the duration of weaning from ventilator. The use of automated or protocolized weaning can reduce the duration of postoperative mechanical ventilation in comparison with non-protocolized weaning based on the physician's decision.

Role of dexmedetomidine in myocardial protection during beating coronary artery bypass grafting.

Background: On-pump CABG is associated with a high risk of myocardial injuries and other complications that result into myocardial ischemia and arrhythmias. OPCAB surgery may reduce, although not entirely eliminate, these myocardial injuries. This prospective study was designed to determine whether the intraoperative use of Dexmedetomidine could reduce the incidence of myocardial injuries after off pump CABG. Methods: A total of 100 patients who underwent off-pump coronary artery bypass surgery were included and randomly divided into Dexmedetomidine treated and Control groups (groups B and A, respectively) 50 patients in each groups. Following the first vascular anastomosis grafting, the patients in group B received a loading dose of 0.5 μg/kg/10min of Dexmedetomidine via central venous catheter followed by a continuous infusion of 0.5 μg/kg/hr of Dexmedetomidine. The infusion was discontinued at the end of surgery. In group A, 0.9% physiological saline was infused using identical methods to group B. Results: The primary outcomes measured included serum levels of cardiac biomarkers like CPK-MB & Trop I. Secondary outcomes included hemodynamic stability, ischemia or arrhythmia events & post-operative ICU stay. Dexmedetomidine use significantly reduced postoperative CPK-MB (26.38 ± 7.11 v/s 30.48 ± 9.84, P=0.019) & Trop I (0.678 ± 0.742 v/s 1.011 ± 0.67, P=0.021) at 24 & 48 hours respectively. Intraoperative dexmedetomidine therapy also reduced the risk of overall complications. Conclusion: Intra operative administration of low-dose dexmedetomidine reduces myocardial damage during off-pump coronary artery bypass grafting surgery as indicated by significantly decreased level of cardiac biochemical markers, CK-MB and cTnI post-operatively.

Endotracheal bioimpedance cardiography improves immediate postoperative outcome: a case-control study in off-pump coronary surgery

The feasibility and clinical utility of the endotracheal cardiac output monitor (ECOM) to optimize intraoperative hemodynamics and improve short-term outcome in off-pump coronary artery bypass grafting (OPCAB) is unknown. We aimed to compare ECOM with a standard of care in that specific surgical setting. Twenty consecutive adult ECOM-monitored patients undergoing OPCAB were prospectively included (ECOM group) and retrospectively compared to 42 patients scheduled for similar surgery without ECOM monitoring (Control group). The primary endpoint was the global rate of postoperative admission to the intensive care unit (ICU). Secondary endpoints were the time to extubation, the length of stay in ICU and in hospital, the postoperative levels of lactate and troponin and the feasibility of ECOM. The rate of postoperative admission to the ICU was 38/42 (90%) in the Control group versus 11/20 (55%) in the ECOM group, P = 0.008. None unexpected admission for hemodynamic instability was observed in the ECOM group. The time to extubation, the length of stay in ICU, and both troponin level at admission and lactate level at H6 were all significantly decreased in the ECOM group. On a scale ranging from 0 to 5, convenience and satisfaction regarding ECOM were 4.30 ± 1.17 and 3.45 ± 0.68, respectively. The systematic use of ECOM is associated with a significant reduction in the rate of admission to the ICU and an improvement in immediate outcome in OPCAB.

One or Two Internal Thoracic Grafts? Long-Term Follow-Up of 957 Off-Pump Coronary Bypass Surgeries

The potential survival benefit of bilateral internal thoracic artery (BITA) grafting in patients undergoing off-pump coronary artery bypass graft surgery (OPCABG) is controversial owing to the technical complexity of these operations. Our objective was to compare the outcome of patients undergoing OPCABG with BITA to the outcome of patients undergoing OPCABG with a single internal thoracic artery (SITA) and saphenous vein grafts or radial artery. Five hundred and thirty-five consecutive patients who underwent OPCABG BITA at our institute between 2000 and 2008 were compared with 422 patients who underwent OPCABG with SITA. Propensity score matching was used to account for differences between groups in preoperative characteristics. Being female (20.9% versus 36.0%, p < 0.001), having diabetes mellitus (36.6% versus 55.7%, p > 0.001), recent myocardial infarction (23.6% versus 33.2%, p>0.001), aged 70 years or more (41.1% versus 49.8%, p=0.001), peripheral vascular disease (26.1% versus 46.7%, p > 0.001), and chronic renal failure (7.9% versus 15.9%, p > 0.001) were less frequent in the BITA group than in the SITA group, respectively. The European System for Cardiac Operative Risk Evaluation score was significantly higher for the SITA group (7.62, versus 5.46 for BITA group, p= 0.001), whereas operative mortality (1.7% BITA versus 2.6% SITA) and sternal wound infections (1.7% BITA versus 2.1% SITA) were similar. The mean follow-up was 11.6 ± 3.5 years. The BITA patients' 10-year survival (Kaplan-Meier) was better (72.2% versus 55.1% for SITA, p> 0.001). However, after propensity matching, survival for BITA and SITA were similar. This large cohort study suggests that long-term outcomes for patients undergoing OPCABG are not better with BITA grafting.

Investigation of the effect of Acute Normovolemic Hemodilution and Tranexamic Acid on the amount of bleeding during off-pump coronary artery bypass graft surgery: a systematic review

Introduction: Postoperative bleeding and transfusion remain a source of morbidity and cost after open heart operations . To evaluate the effect of ANH method and tranexamic acid on blood transfusion requirements and blood loss after off pump coronary artery bypass surgery (OPCAB). Materials and Methods: The Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE from inception to December 2014; reference lists of published guidelines, reviews, and associated articles, as well as conference proceedings.We included articles with available abstract in English language. Manual searching was done within the reference list of articles. Three reviewers independently reviewed and assessed eligibility criteria, assessed quality, and extracted data. Results: Bleeding and hemorrhagic complications and the consequent need for allogeneic transfusion are still major problems after off-pump coronary artery bypass surgery that can reduced in combination of ANH method and tranexamic acid. Conclusion: Tranexamic acid and ANH appear to be effective in reducing postoperative bleeding and the need for allogeneic blood products.Â

Foreword: Fast track in aortic valve surgery

‘Fast track’ in cardiac surgery includes early extubation, a short stay in the intensive care unit, and early discharge from the hospital.1 Although several centres were familiar with an early extubation of selected low-risk cardio-surgical patients in the odds ratio , the term ‘Fast Track’ was first coined in the 1990s.2 Limited resources were the main driving force for the development of more standardized fast track protocols when huge cardiac programs of more than 10 surgical cases a day required reliable intensive care unit (ICU) capacities. In most cardiac centres, so called intermediate care units (IMC) were established in these days also, to improve the ‘flow’ of patients and close the gap between ICU and care in a standard ward. The comprehensive care in intermediate care units with extended monitoring and specialized staff, usually in a 1–4 nurse-patient ratio, made early extubation and avoidance of the ICU for low risk cardio-surgical patients, notably CABG in younger ages, possible.3–6 The evolution of less invasive techniques in cardiac surgery, such as the off-pump coronary bypass surgery, further stimulated the fast track programs, which not only benefitted patients but also aimed to improve the cost effectiveness of cardiac surgical programs.7 Nowadays, cardiac surgery is faced with an increasing number of elderly, frail, and comorbid patients. The number of …

Atan Kalpte Koroner Arter Baypas Greft Cerrahisi Yapılan Yaşlılarda Farklı Anestezi Tekniklerinin Zihin Üzerindeki Sonuçları

Atan Kalpte Koroner Arter Baypas Greft Cerrahisi Yapılan Yaşlılarda Farklı Anestezi Tekniklerinin Zihin Üzerindeki Sonuçları

The Effect of On‐Pump and Off‐Pump Bypass Operations on Oxidative Damage and Antioxidant Parameters

Objective The aim of the study is to determine the oxidative status in on-pump and off-pump coronary artery surgery and contribute to possible surgical choices in clinical practices in accordance with the information obtained as a result of this study. Methods 52 patients undergoing open heart surgery (26 patients in on-pump group and 26 patients in off-pump group) were included in the study. MDA, GPx, GSH, CAT, and SOD were investigated in blood samples. Results In the on-pump group, it was determined that there were a significant increase in MDA level in the peroperative period compared to the preoperative and postoperative periods and a significant increase in GSH level in the postoperative period than in the preoperative period. Additionally, while there was a significant decrease in CAT activity in the postoperative period than in the peroperative period, there was a statistically significant increase in SOD enzyme activity in the postoperative period compared to the preoperative and peroperative periods. A statistically significant increase was observed in SOD enzyme activity in the postoperative period in on-pump compared to off-pump group. Conclusion It is thought that this oxidative damage can be suppressed by administering a suitable antioxidant supplement in the preoperative and peroperative periods among patients undergoing the on-pump operation.