The benefits of off-pump coronary artery bypass surgery over traditional coronary artery bypass surgery in reducing the risk of postoperative stroke are debatable. Because of the recent clinical experience, this topic has been assessed. In 557 patients, off-pump coronary artery bypass surgery was performed, while in 445 patients, conventional coronary artery bypass surgery was conducted. The Northern New England Cardiovascular Disease Study Group stroke risk-scoring technique calculated preoperative stroke risk. In the overall series, off-pump coronary artery bypass surgery was associated with a lower but not significant rate of postoperative stroke (1.8% vs.. 2.5%, P=.45), a difference that increased slightly in the highest tertile of the Northern New England Cardiovascular Disease Study Group score (2.8% vs.. 4.2%, P=.75). Off-pump coronary artery bypass surgeons who used routine periaortic ultrasonographic scanning had a considerably lower postoperative stroke rate (0.4% vs. 3.9%, P=.015) than conventional coronary artery bypass surgeons who did not use periaortic ultrasonographic scanning.
The Northern New England Cardiovascular Disease Study Group score was similar (mean, 4.6±2.1 vs.. 4.9±2.2; P=.189). When adjusted for stroke risk score and critical preoperative status, logistic regression revealed that the treatment approach (off-pump coronary artery bypass surgery and routine periaortic ultrasonographic scanning) was an independent predictor of postoperative stroke (P=.012; odds ratio, 34.1; 95% confidence interval, 2.2-533.7). Off-pump coronary artery bypass surgery has a modest neuroprotective efficacy than traditional coronary artery bypass surgery. After off-pump coronary artery bypass surgery, a lower risk of postoperative stroke is expected, especially in high-risk patients and when periaortic ultrasonographic evaluation is frequently performed to improve surgical strategy planning and reduce the risk of intraoperative embolism.
Reference:www.jtcvs.org/article/S0022-5223(06)01710-7/fulltext
