Implementation of the aortic no-touch technique to reduce stroke after off-pump coronary surgery

The Journal of Thoracic and Cardiovascular Surgery
Alexander AlbertAlexander Assmann

Abstract

Despite substantial scientific effort, the relationship between stroke after coronary artery bypass grafting and the use of the aortic no-touch off-pump technique (anOPCAB) remains incompletely understood. The present study aimed to define the effect of anOPCAB on the occurrence and time point of stroke. A total cohort of 15,042 consecutive patients underwent surgical myocardial revascularization at a single institution. After establishing anOPCAB as routine procedure, 4695 patients received surgery by 18 different surgeons using the anaortic approach. After the exclusion of all patients with cardiogenic shock and "side-clamp" off-pump coronary artery bypass grafting, 13,279 patients (4485 with anOPCAB) were included in the study. Perioperative strokes were classified as strokes occurring during the hospital stay, with early strokes observed immediately after emergence from anesthesia (vs delayed strokes). The anOPCAB technique reduced the postoperative stroke rate to 0.49% versus 1.31% in on-pump patients (P < .0001). The overall stroke rate after adoption of anOPCAB (0.64%) decreased compared with before its adoption (1.40%; P < .0001). With anOPCAB, the risk of early strokes virtually disappeared to 4 of 4485 patients (0.09%...Continue Reading

Citations

Apr 16, 2019·Circulation·John D PuskasDavid P Taggart
Jun 28, 2019·Journal of the American Heart Association·Mario GaudinoDavid P Taggart
Jun 20, 2019·Journal of the American Heart Association·Mario GaudinoStephen Fremes
Apr 16, 2020·Journal of Cardiac Surgery·Gianluca TorregrossaHusam H Balkhy
Sep 7, 2019·Open Journal of Cardiovascular Surgery·Sotirios N PrapasKonstantinos Grapatsas
Oct 2, 2020·Current Opinion in Cardiology·Aaron J WeissFaisal G Bakaeen
Nov 19, 2019·The Journal of Thoracic and Cardiovascular Surgery·Hitoshi TachibanaTaichi Sakaguchi
Jan 28, 2021·Journal of Cardiac Surgery·Fabio RamponiMichael P Vallely
Nov 7, 2019·The Journal of Thoracic and Cardiovascular Surgery·Krzysztof SzwedAlina Borkowska
Nov 19, 2018·The Journal of Thoracic and Cardiovascular Surgery·Gianluca Torregrossa, John D Puskas
Jul 24, 2021·Interventional Cardiology·Karel M Van PraetStephan Jacobs

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.