Abstract
Objective: Most studies comparing off-pump coronary artery bypass grafting (OPCAB) with conventional
on-pump coronary artery bypass grafting (ONCAB) include patients with aortic manipulation
in the OPCAB group. Performing OPCAB without aortic manipulation, i.e., “anaortic”
OPCAB (anOPCAB), may improve neurological outcome. Methods: We reviewed the perioperative data of all isolated CABG patients at two metropolitan
hospitals for the period from January 2002 to December 2007. Multiple logistic regression
analysis was performed to determine whether the type of procedure was an independent
predictor of adverse neurological outcome. Results: Out of a total of 3699 consecutive patients, 1346 were anOPCAB, 600 OPCAB and 1753
ONCAB cases. Neurological complications occurred in 0.9 % of all patients. Compared
to the anOPCAB group, there was a statistically significant higher odds for neurological
complications in the OPCAB group [odds ratio (OR) 7.01, 95 % confidence interval (CI)
1.4–35.0, p = 0.0175] and in the ONCAB group (OR 12.33, 95 % CI 2.9–52.2, p = 0.0007). Conclusions: In this series “anaortic” OPCAB surgery significantly decreases the risk of neurological
complications compared to both ONCAB and OPCAB with aortic manipulation. If possible,
we advocate avoiding aortic manipulation in OPCAB surgery.
Key words
coronary bypass surgery - stroke - cardiopulmonary bypass - off‐pump
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Dr. Martin Misfeld, MD. PhD
Department of Cardiac Surgery Heart Centre Leipzig
Struempellstr. 39
04289 Leipzig
Germany
Email: martinmisfeld@yahoo.com