Incidence of perioperative stroke in clampless aortic anastomosis during off-pump coronary artery bypass grafting.
This study aimed to assess if clampless off-pump coronary artery bypass grafting (OPCAB) decreases the incidence of perioperative stroke (POS) rate and in-hospital mortality. The secondary aim was to evaluate 12-year rates of overall mortality. Between January 2003 to December 2015, data of 645 consecutive patients undergoing isolated CABG were retrospectively collected. 363 underwent aortic no-touch OPCAB (No-touch group) and 282 underwent OPCAB with the Heartstring device (HS group). In-hospital mortality and perioperative stroke rate as primary endpoint, as well as long-term follow-up outcome were analysed. In-hospital mortality was lower into No-touch group compared with HS group but without significant statistical difference (1.7 vs. 3.2%, p = 0.19, respectively); the rate of postoperative stroke was higher in No-touch group compared with HS group, although this difference did not reach statistically significance. Delirium was reported with higher presentation rate in HS group (3.9 vs. 0.8%, p = 0.01). Blood transfusions rate was higher in HS subjects (23.4 vs. 16.1%, p = 0.01). Intubation time, ICU, and hospital length of stay were increased in the HS group (p = 0.008, p = 0.001 and p = 0.003, respectively). Over a 12-year follow-up period, survival probabilities at 1, 5, and 10 years were 93.6 ± 1.3 vs. 93.2 ± 1.5, 80.4 ± 2.6 vs. 80.3 ± 2.2, and 57.9 ± 5 vs. 58.4 ± 3.8% in the No-touch and HS group, respectively (p = 0.97). In this retrospective study, clampless off-pump CABG lowers perioperative stroke rate whose incidence is, however, not inferior compared with No-touch technique, and no statistically significance was detected. Delirium has a higher presentation rate in clampless off-pump CABG.
['Formica|Francesco|F|', 'Tata|Giuseppe|G|', 'Singh|Gurmeet|G|', 'Mariani|Serena|S|', "D'Alessandro|Stefano|S|", 'Messina|Luigi Amerigo|LA|', 'Sangalli|Fabio|F|', 'Paolini|Giovanni|G|']
D000368:Aged D000369:Aged, 80 and over D000714:Anastomosis, Surgical D001013:Aorta, Thoracic D047549:Coronary Artery Bypass, Off-Pump D003331:Coronary Vessels D005260:Female D017052:Hospital Mortality D006801:Humans D015994:Incidence D007558:Italy D008297:Male D011183:Postoperative Complications D012189:Retrospective Studies D012307:Risk Factors D020521:Stroke D015996:Survival Rate
Stroke CABG Clampless anastomosis Off-pump surgery