Article

Coronary artery bypass grafting with and without manipulation of the ascending aorta--a meta-analysis.

Cardiothoracic Surgical Unit, Royal Prince Alfred Hospital, Sydney, Australia.
Heart Lung &amp Circulation (impact factor: 1.2). 05/2011; 20(5):318-24. DOI:10.1016/j.hlc.2011.02.003 pp.318-24
Source: PubMed

ABSTRACT The main criticism of surgery in the SYNTAX trial was increased rate of stroke when compared to percutaneous coronary intervention. We aimed to determine whether avoiding aortic manipulation would decrease the rate of stroke.
We performed a meta-analysis of seven studies comparing coronary artery bypass grafting (CABG) with and without manipulation of the ascending aorta.
When anaortic off-pump coronary artery bypass grafting (OPCAB) was compared with conventional CABG, the rate of stroke was 0.38% vs. 1.87% (p<0.0001). When anaortic OPCAB was compared with OPCAB using a side-clamp or proximal graft anastomosis device the rate of stroke was 0.31% vs. 1.35% (p=0.003).
Avoiding aortic manipulation during CABG may decrease the rate of peri-operative stroke.

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Keywords

anaortic off-pump coronary artery bypass grafting
 
anaortic OPCAB
 
aortic manipulation
 
ascending aorta
 
Avoiding aortic manipulation
 
conventional CABG
 
coronary artery bypass grafting
 
main criticism
 
manipulation
 
meta-analysis
 
OPCAB
 
percutaneous coronary intervention
 
proximal graft anastomosis device
 
side-clamp