Key result
Cardiopulmonary bypass during CABG surgery showed no difference in the incidence of stroke or cognitive deficit compared to off-pump CABG.
Why the study?
Does cardiopulmonary bypass (on-pump vs off-pump CABG) increase the risk of stroke or cognitive deficit in patients undergoing CABG?
Does cardiopulmonary bypass (on-pump vs off-pump CABG) increase the risk of stroke or cognitive deficit in patients undergoing CABG?
This review challenges the long-held belief that cardiopulmonary bypass is the primary cause of brain damage during heart surgery, finding no difference in stroke or cognitive outcomes between on-pump and off-pump CABG.
Brain damage, in the form of stroke and cognitive deficit associated with heart surgery, has long been attributed unquestioningly to cardiopulmonary bypass (CPB). The aim of this paper is to review the randomised control trials (RCT), systematic reviews and meta-analyses of studies, comparing patients who have undergone on- or off-pump coronary artery bypass grafting (CABG) surgeries that have used stroke or cognition as an outcome to determine whether CPB is associated with brain damage. Although not definitive, the evidence base to date strongly suggests that the incidence of stroke and the effect on cognition, if any, are no different whether CABG surgery is undertaken on- or off-pump. In addition and contrary to long-held beliefs, this review leads to the conclusion that CPB may well not be the cause of the brain damage associated with heart surgery.
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R. Peter Alston (2011) conducted a review in Coronary artery bypass grafting (CABG). On-pump CABG (Cardiopulmonary bypass) vs. Off-pump CABG was evaluated on Stroke or cognitive deficit. Cardiopulmonary bypass during CABG surgery showed no difference in the incidence of stroke or cognitive deficit compared to off-pump CABG.
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