WEDNESDAY, Feb. 22, 2017 (HealthDay News) — Anaortic off-pump coronary artery bypass grafting (anOPCABG) is associated with reduced risk of postoperative stroke compared with other CABG techniques, according to a meta-analysis published in the Feb. 28 issue of the Journal of the American College of Cardiology.
Dong Fang Zhao, from the University of Sydney, and colleagues conducted a network meta-analysis to compare postoperative outcomes between all CABG techniques. Data were included for 13 studies with 37,720 patients. Techniques included anOPCABG, off-pump with the clampless Heartstring device (OPCABG-HS), off-pump with a partial clamp (OPCABG-PC), and traditional on-pump CABG with aortic cross-clamping.
The researchers found that anOPCABG patients had higher previous stroke than OPCABG-PC and CABG patients (7.4 percent versus 6.5 and 3.2 percent, respectively) at baseline. The most effective treatment for decreasing the risk of postoperative stroke was anOPCABG (−78 percent versus CABG; −66 percent versus OPCABG-PC; and −52 percent versus OPCABG-HS). AnOPCABG was also most effective for reducing the risk of mortality (−50 percent versus CABG and −40 percent versus OPCABG-HS), renal failure (−53 percent versus CABG), bleeding complications (−48 percent versus OPCABG-HS and −36 percent versus CABG), and atrial fibrillation (−34 percent versus OPCABG-HS; −29 percent versus CABG; and −20 percent versus OPCABG-PC), and shortening the length of intensive care unit stay (−13.3 hours).
“Avoidance of aortic manipulation in anOPCABG may decrease the risk of postoperative stroke, especially in patients with higher stroke risk,” the authors write.
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