Combined use of off-pump techniques and a sutureless proximal aortic anastomotic device reduces cerebral microemboli generation during coronary artery bypass grafting

Department of Surgery, Duke University, Durham, North Carolina, United States
Journal of Thoracic and Cardiovascular Surgery (Impact Factor: 4.17). 11/2003; 126(5):1561-7. DOI: 10.1016/S0022-5223(03)01039-0
Source: PubMed


Intraoperative cerebral microemboli are associated with the development of postoperative stroke and neurocognitive decline in patients undergoing coronary artery bypass grafting. Although cardiopulmonary bypass is responsible for the generation of a significant number of such emboli, the elimination of cardiopulmonary bypass alone has not been conclusively shown to improve neurocognitive outcome. The current study was performed to determine the effects of combined off-pump coronary artery bypass grafting and sutureless proximal aortic anastomotic techniques on the generation of intraoperative cerebral microemboli compared with standard coronary artery bypass grafting techniques of cardiopulmonary bypass and hand-sewn proximal anastomoses.

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Available from: Joseph P Mathew, Feb 23, 2015
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    • "A "no-touch" technique may be used in off-pump CABG and alternative route CPB [37]. A sutureless proximal aortic anastamotic technique has been shown to reduce micro-embolic counts on transcranial Doppler [38]. "
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    • "Manipulation of the atherosclerotic aorta by cannulation and clamping can be associated with intraoperative embolization into the cerebral circulation, resulting in persistent cognitive deficit or post-operative stroke [2]. Although aortic manipulation associated with cardiopulmonary bypass is responsible for the generation of cerebral emboli, the elimination of cardiopulmonary bypass alone has not been conclusively shown to improve the long-term neurologic outcomes [1]. "
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