Key result
Aortic cross-clamping significantly increased the estimate of post-CABG ischemic stroke to 0.075, whereas additional aortic manipulation from a side-biting clamp or multiple touches did not.
Why the study?
Does the type of surgical technique and degree of aortic manipulation affect the incidence of postoperative ischemic stroke in patients undergoing isolated CABG?
Observational (n=16,255)
Yes
Does the type of surgical technique and degree of aortic manipulation affect the incidence of postoperative ischemic stroke in patients undergoing isolated CABG?
Absolute Event Rate: 0.075% vs 0.018%
Total aortic cross-clamping is the primary cause of post-CABG ischemic stroke, while additional aortic manipulation from a side-biting clamp, on-pump surgery, or multiple aortic touches do not significantly increase the risk.
Aortic cross-clamping may raise post-CABG stroke risk; leaves open whether limiting additional manipulation confers further benefit.
Aortic cross-clamping was found to be the primary cause of post-CABG ischemic stroke. Instead, additional aortic manipulation from a side-biting clamp, on-pump surgery, multiple aortic touches, number of proximal anastomoses, and aortic cannulation were found not to increase the estimate of stroke significantly. Further research on this topic is warranted.
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Gelsomino et al. (2021) conducted an observational in Ischemic stroke following Coronary Artery Bypass Grafting (CABG) (n=16,255). Aortic cross-clamping vs. Off-pump surgery or on-pump surgery without an aortic cross-clamp was evaluated on Postoperative ischemic stroke within 30 days (95% CI 0.061-0.088). Aortic cross-clamping significantly increased the estimate of post-CABG ischemic stroke to 0.075, whereas additional aortic manipulation from a side-biting clamp or multiple touches did not.
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