Incidence of Stroke in On-Pump Versus Off-Pump Coronary Artery Bypass Grafting: A Metanalysis on 11,500 Patients

Author(s): Linda Renata Micali, Wael Alruwaili, Monique MJ de Jong, Orlando Parise, Amalia Ioanna Moula, Gianmarco Parise, Francesco Matteucci, Cecilia Tetta, Sandro Gelsomino

Background and Aims: Conventional coronary artery bypass grafting (CCABG) has been associated with high incidence of stroke, especially for the high degree of aortic manipulation. Off-pump CABG (OPCAB) theoretically represents a valid option, since the avoidance of aortic manipulation can prevent the embolization of atherosclerotic debris. There is a lot of controversy about the outcomes of CCABG compared to OPCAB. The aim of this metanalysis is to examine the incidence of stroke within 30 days from the surgical procedure.

Methods and Results: A literature search was conducted from 2009 to 2019 using PubMed database. Nine randomized control trials were included in the metanalysis.

Results: The odds ratio between the CCABG vs OPCAB was 0.87 (Lower, Upper limits: 0.65, 1.17, p = 0.355; I2 = 0.0%, p = 0.68; Egger’s test: intercept -0.15 [-1.55, 1.25], p = 0.81).

Conclusion: Compared to the CCABG, no advantage was detected in the OPCAB group in terms of stroke.

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