Use of Carbon dioxide versus air blower in on-pump beating-heart coronary artery bypass surgery

Introduction:  The use of carbon dioxide blower has been recognized as the standard of care in patients undergoing beating coronary artery bypass grafting (CABG) due to higher solubility and lower risk of embolization. On the other hand, the compressed air blower has gone out of use since air can be easily trapped and is less soluble which can cause coronary embolism. The present study aimed to compare the outcomes of patients undergoing on-pump beating CABG using CO2, as opposed to an air blower. Materials and Methods: A total number of 125 patients requiring coronary revascularization underwent on-pump beating CABG within February 2017-February 2018. In the current cross sectional study, 45 patients underwent CABG with CO2 blower and other patients were operated using air blower. The reported postoperative outcomes included mortality, low cardiac output state, malignant arrhythmia, postoperative myocardial infarction, blood transfusion, transient ischemic attack or stroke, intra-aortic balloon pump (IABP), as well as intensive care unit and hospital length of stay. Results:Demographic characteristics of patients in two groups in terms of age, sex, risk factors, echocardiographic and angiography data were similar and demonstrated no significant difference. Patients' outcomes, such as cardiac arrhythmias, myocardial infarction, ICU and hospital stays, were also similar in both groups. In addition, the overall morbidity and hospital mortality showed no significant difference between the two groups. Conclusion: Although the use of CO2 during beating CABG has been advocated with its theoretical advantages, no significant difference was observed between the two groups in terms of mortality and morbidity using CO2, as opposed to air blower.