Off-pump coronary artery bypass surgery may reduce the incidence of stroke in patients with significant left main stem disease

Sukmeet Singh Panesar, J. Chikwe, S. B. Mirza, M. S. Rahman, O. Warren, C. Rao, J. Negus, E. Zacharakis, A. Darzi, T. Athanasiou

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Background: Off-pump coronary artery bypass (OPCAB) surgery in patients with left main stem (LMS) disease remains controversial. This meta-analysis cpmpares early outcomes of OPCAB surgery with on-pump coronary artery bypass (ON-CAB) surgery in patients with significant LMS disease, focusing on the outcomes stroke and transient ischemic attack (TIA). Methods: This is a meta-analysis of non-randomized comparative peer-reviewed publications sourced from a systematic search of Embase, Medline, Cochrane, Google Scholar and CINAHL (1965-2007). A random effects model was used and heterogeneity was assessed. Results: Nine studies (4411 patients) dating from 2000-2007, of whom 1036 (23.5%) underwent OPCAB and 3375 (76.5%) ONCAB, were included. The incidence of stroke was lower in the OPCAB group (OR 0.17 [95% Cl 0.05 to 0.60]). Early mortality, length of hospital stay, blood loss and inotropic requirements were significantly favored by OPCAB surgery. Conclusions: OPCAB may offer a neurological benefit in patients with significant LMS disease undergoing coronary artery bypass grafting.

Original languageEnglish
Pages (from-to)247-255
Number of pages9
JournalThoracic and Cardiovascular Surgeon
Volume56
Issue number5
DOIs
StatePublished - Aug 2008
Externally publishedYes

Keywords

  • Cardiovascular surgery
  • Coronary bypass surgery
  • Myocardial protection

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