Cerebrovascular events after no-touch off-pump coronary artery bypass grafting, conventional side-clamp off-pump coronary artery bypass, and proximal anastomotic devices: A meta-analysis

Wojciech Pawliszak, Mariusz Kowalewski, Giuseppe Maria Raffa, Pietro Giorgio Malvindi, Magdalena Ewa Kowalkowska, Krzysztof Aleksander Szwed, Alina Borkowska, Janusz Kowalewski, Lech Anisimowicz

Research output: Contribution to journalArticle

Abstract

Background--Off-pump coronary artery bypass (OPCAB) has been shown to reduce the risk of neurologic complications as compared to coronary artery bypass grafting performed with cardiopulmonary bypass. Side-clamping of the aorta while constructing proximal anastomoses, however, still carries substantial risk of cerebral embolization. We aimed to perform a comprehensive meta-analysis of studies assessing 2 clampless techniques: aortic "no-touch" and proximal anastomosis devices (PAD) for OPCAB. Methods and Results--PubMed, CINAHL, CENTRAL, and Google Scholar databases were screened for randomized controlled trials and observational studies comparing "no-touch" and/or PAD with side-clamp OPCAB and reporting short-term (=30 days) outcomes: cerebrovascular accident and all-cause mortality. A total of 18 studies (3 randomized controlled trials) enrolling 25 163 patients were included. Aortic "no-touch" was associated with statistically lower risk of cerebrovascular accident as compared to side-clamp OPCAB: risk ratio 95% CI: 0.41 (0.27-0.61); P

Original languageEnglish
Article numbere002802
JournalJournal of the American Heart Association
Volume5
Issue number2
DOIs
Publication statusPublished - 2016

Keywords

  • Bypass surgery
  • Coronary circulation
  • Meta-analysis
  • Revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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