Off-pump coronary artery bypass grafting reduces postoperative neurologic complications

Alberto Zangrillo, Giuseppe Crescenzi, Giovanni Landoni, Albino Leoni, Giovanni Marino, Maria G. Calabrò, Chiara Corno, Federico Pappalardo, Ottavio Alfieri

Research output: Contribution to journalArticle

Abstract

Objective: Complications occurring after coronary artery bypass graft (CABG) surgery, particularly neurologic damage, have been mainly correlated with the use of cardiopulmonary bypass (CPB). The aim of this work was to compare postoperative outcomes of patients undergoing CABG surgery, with or without the use of CPB, focusing on neurologic events. Design: Observational study. Setting: University tertiary care hospital. Participants: Two thousand seven hundred and forty consecutive patients who underwent CABG surgery in the period January 1998 to January 2003. Interventions: None. Measurements and Main Results: For 738 patients, the operation was performed off-pump (OP group), and for 2002 patients CPB was used (CPB group). OP and CPB groups were compared with regard to preoperative status, anesthetic management, and postoperative outcomes, by means of univariate and multivariate analyses. Surgeons' propensity to operate off-pump was based on patients' age, renal conditions, and hemodynamics. Univariate and multivariate analyses showed that CPB was associated with a higher incidence of type I neurologic events compared with OP technique (2.1% versus 0.9%, odds ratio [OR]: 2.6, 95% confidence interval [CI], 1.2-5.9). A history of previous stroke (OR: 2.7, 95% CI, 1.2-5.9) and advanced age (OR: 1.06 per year, 95% CI, 1.02-1.09) were additional independent predictors of postoperative type I neurologic events. Conclusions: In the authors' experience, off-pump CABG surgery offers some benefits compared with CPB in respect to major neurologic complications.

Original languageEnglish
Pages (from-to)193-196
Number of pages4
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume19
Issue number2
DOIs
Publication statusPublished - Apr 2005

Fingerprint

Off-Pump Coronary Artery Bypass
Cardiopulmonary Bypass
Coronary Artery Bypass
Nervous System
Transplants
Odds Ratio
Confidence Intervals
Multivariate Analysis
Tertiary Healthcare
Tertiary Care Centers
Observational Studies
Anesthetics
Hemodynamics
Stroke
Kidney
Incidence

Keywords

  • Cardiopulmonary bypass
  • Complications
  • Coronary artery bypass surgery
  • Neurologic injury
  • Off-pump
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Off-pump coronary artery bypass grafting reduces postoperative neurologic complications. / Zangrillo, Alberto; Crescenzi, Giuseppe; Landoni, Giovanni; Leoni, Albino; Marino, Giovanni; Calabrò, Maria G.; Corno, Chiara; Pappalardo, Federico; Alfieri, Ottavio.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 19, No. 2, 04.2005, p. 193-196.

Research output: Contribution to journalArticle

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abstract = "Objective: Complications occurring after coronary artery bypass graft (CABG) surgery, particularly neurologic damage, have been mainly correlated with the use of cardiopulmonary bypass (CPB). The aim of this work was to compare postoperative outcomes of patients undergoing CABG surgery, with or without the use of CPB, focusing on neurologic events. Design: Observational study. Setting: University tertiary care hospital. Participants: Two thousand seven hundred and forty consecutive patients who underwent CABG surgery in the period January 1998 to January 2003. Interventions: None. Measurements and Main Results: For 738 patients, the operation was performed off-pump (OP group), and for 2002 patients CPB was used (CPB group). OP and CPB groups were compared with regard to preoperative status, anesthetic management, and postoperative outcomes, by means of univariate and multivariate analyses. Surgeons' propensity to operate off-pump was based on patients' age, renal conditions, and hemodynamics. Univariate and multivariate analyses showed that CPB was associated with a higher incidence of type I neurologic events compared with OP technique (2.1{\%} versus 0.9{\%}, odds ratio [OR]: 2.6, 95{\%} confidence interval [CI], 1.2-5.9). A history of previous stroke (OR: 2.7, 95{\%} CI, 1.2-5.9) and advanced age (OR: 1.06 per year, 95{\%} CI, 1.02-1.09) were additional independent predictors of postoperative type I neurologic events. Conclusions: In the authors' experience, off-pump CABG surgery offers some benefits compared with CPB in respect to major neurologic complications.",
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AU - Crescenzi, Giuseppe

AU - Landoni, Giovanni

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AU - Marino, Giovanni

AU - Calabrò, Maria G.

AU - Corno, Chiara

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N2 - Objective: Complications occurring after coronary artery bypass graft (CABG) surgery, particularly neurologic damage, have been mainly correlated with the use of cardiopulmonary bypass (CPB). The aim of this work was to compare postoperative outcomes of patients undergoing CABG surgery, with or without the use of CPB, focusing on neurologic events. Design: Observational study. Setting: University tertiary care hospital. Participants: Two thousand seven hundred and forty consecutive patients who underwent CABG surgery in the period January 1998 to January 2003. Interventions: None. Measurements and Main Results: For 738 patients, the operation was performed off-pump (OP group), and for 2002 patients CPB was used (CPB group). OP and CPB groups were compared with regard to preoperative status, anesthetic management, and postoperative outcomes, by means of univariate and multivariate analyses. Surgeons' propensity to operate off-pump was based on patients' age, renal conditions, and hemodynamics. Univariate and multivariate analyses showed that CPB was associated with a higher incidence of type I neurologic events compared with OP technique (2.1% versus 0.9%, odds ratio [OR]: 2.6, 95% confidence interval [CI], 1.2-5.9). A history of previous stroke (OR: 2.7, 95% CI, 1.2-5.9) and advanced age (OR: 1.06 per year, 95% CI, 1.02-1.09) were additional independent predictors of postoperative type I neurologic events. Conclusions: In the authors' experience, off-pump CABG surgery offers some benefits compared with CPB in respect to major neurologic complications.

AB - Objective: Complications occurring after coronary artery bypass graft (CABG) surgery, particularly neurologic damage, have been mainly correlated with the use of cardiopulmonary bypass (CPB). The aim of this work was to compare postoperative outcomes of patients undergoing CABG surgery, with or without the use of CPB, focusing on neurologic events. Design: Observational study. Setting: University tertiary care hospital. Participants: Two thousand seven hundred and forty consecutive patients who underwent CABG surgery in the period January 1998 to January 2003. Interventions: None. Measurements and Main Results: For 738 patients, the operation was performed off-pump (OP group), and for 2002 patients CPB was used (CPB group). OP and CPB groups were compared with regard to preoperative status, anesthetic management, and postoperative outcomes, by means of univariate and multivariate analyses. Surgeons' propensity to operate off-pump was based on patients' age, renal conditions, and hemodynamics. Univariate and multivariate analyses showed that CPB was associated with a higher incidence of type I neurologic events compared with OP technique (2.1% versus 0.9%, odds ratio [OR]: 2.6, 95% confidence interval [CI], 1.2-5.9). A history of previous stroke (OR: 2.7, 95% CI, 1.2-5.9) and advanced age (OR: 1.06 per year, 95% CI, 1.02-1.09) were additional independent predictors of postoperative type I neurologic events. Conclusions: In the authors' experience, off-pump CABG surgery offers some benefits compared with CPB in respect to major neurologic complications.

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KW - Stroke

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