Abstract: Abstract: Objective To compare the long- term complications of off- pump and on- pump coronary artery bypass grafting. Methods CNKI, WanFang Data, VIP, PubMed, EMBASE and the Cochrane Central Register were searched for randomized controlled trials (RCTs) of long-term complications of off-pump and on-pump coronary artery bypass grafting. According to the Cochrane system evaluation method, the quality of the research literature was evaluated by the inclusion and exclusion criteria, and the RevMan5.2 software was used for meta analysis. Results A total of 9 studies were included, including 11 660 patients, 5 794 patients in the OPCABG group and 5 866 cases in the ONCABG group. There was no significant difference in mortality between the OPCABG group and the ONCABG group (OR=1.10, 95%CI: 0.94-1.30，P= 0.22] and no significant difference in myocardial infarction (OR =0.90, 95%CI: 0.76-1.06，P=0.21). However, the difference in revascularization was statistically significant between the two groups (OR=1.41, 95%CI: 1.09-1.83，P=0.009). The longterm incidence of stroke was significantly lower in OPCABG group than that of ONCABG group (OR=0.75, 95%CI: 0.57- 0.98，P=0.04]. Conclusion The on-pump coronary artery bypass grafting can effectively reduce the occurrence of longterm revascularization. However, off-pump coronary artery bypass grafting can effectively reduce the risks of stroke.

Key words: coronary artery bypass, off- pump, extracorporeal circulation, postoperative complications, mortality, myocardial infarction, stroke, Meta-analysis, on pump coronary artery bypass grafting, revascularization