Aortic clamping strategy and postoperative stroke

The Journal of Thoracic and Cardiovascular Surgery
Mohamad AlaeddineDanny Chu

Abstract

The effect of aortic clamping strategy on short-term stroke during proximal graft construction for coronary artery bypass grafting (CABG) remains undefined. The aim of this study was to test the hypothesis that partial occluding clamp (POC) technique does not increase incidence of postoperative stroke compared with single clamp (SC) technique for performing proximal coronary anastomoses. We identified 52,611 patients who underwent on-pump CABG in the Society of Thoracic Surgeons Adult Cardiac Surgery Database from July 1, 2014 to March 31, 2015. Propensity scores for POC were calculated on the basis of validated Society of Thoracic Surgeons predicted risk of postoperative stroke scores and used to adjust for intergroup differences to derive 17,819 matched pairs for analysis. Despite a similar number of total bypass grafts between matched SC versus POC groups, myocardial ischemic times were shorter (74.1 ± 29.2 minutes vs 57.0 ± 23.3 minutes; P < .0001) as were cardiopulmonary bypass times (95.0 ± 35.0 minutes vs 89.7 ± 34.4 minutes; P < .0001) for the POC group. Postoperative stroke rates were similar between SC versus POC (0.9% vs 1.1%; risk ratio, 1.1; 95% confidence interval, 0.9-1.4; P = .3) as were mortality rates (1.3% vs...Continue Reading

Citations

Dec 20, 2018·Circulation·Marc RuelDavid P Taggart
Aug 28, 2020·Circulation·Mario GaudinoUNKNOWN American Heart Association Council on Cardiovascular Surgery and Anesthesia; Stroke Council; and Council on Cardiovascular a
Jul 31, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Wiebe G KnolAd J J C Bogers
Jul 23, 2021·Frontiers in Cardiovascular Medicine·Sandro GelsominoMassimo Bonacchi

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