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Neurological Complications in High-Risk Patients Undergoing Coronary Artery Bypass Surgery

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Neurological Complications in High-Risk Patients Undergoing Coronary Artery Bypass Surgery. / Naito, Shiho; Demal, Till J; Sill, Björn; Reichenspurner, Hermann; Onorati, Francesco; Gatti, Giuseppe; Mariscalco, Giovanni; Faggian, Giuseppe; Santini, Francesco; Santarpino, Giuseppe; Zanobini, Marco; Musumeci, Francesco; Rubino, Antonino S; De Feo, Marisa; Nicolini, Francesco; Dalén, Magnus; Maselli, Daniele; Bounader, Karl; Mäkikallio, Timo; Juvonen, Tatu; Ruggieri, Vito G; Perrotti, Andrea; Biancari, Fausto.

in: ANN THORAC SURG, Jahrgang 113, Nr. 5, 05.2022, S. 1514-1520.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Naito, S, Demal, TJ, Sill, B, Reichenspurner, H, Onorati, F, Gatti, G, Mariscalco, G, Faggian, G, Santini, F, Santarpino, G, Zanobini, M, Musumeci, F, Rubino, AS, De Feo, M, Nicolini, F, Dalén, M, Maselli, D, Bounader, K, Mäkikallio, T, Juvonen, T, Ruggieri, VG, Perrotti, A & Biancari, F 2022, 'Neurological Complications in High-Risk Patients Undergoing Coronary Artery Bypass Surgery', ANN THORAC SURG, Jg. 113, Nr. 5, S. 1514-1520. https://doi.org/10.1016/j.athoracsur.2021.05.018

APA

Naito, S., Demal, T. J., Sill, B., Reichenspurner, H., Onorati, F., Gatti, G., Mariscalco, G., Faggian, G., Santini, F., Santarpino, G., Zanobini, M., Musumeci, F., Rubino, A. S., De Feo, M., Nicolini, F., Dalén, M., Maselli, D., Bounader, K., Mäkikallio, T., ... Biancari, F. (2022). Neurological Complications in High-Risk Patients Undergoing Coronary Artery Bypass Surgery. ANN THORAC SURG, 113(5), 1514-1520. https://doi.org/10.1016/j.athoracsur.2021.05.018

Vancouver

Naito S, Demal TJ, Sill B, Reichenspurner H, Onorati F, Gatti G et al. Neurological Complications in High-Risk Patients Undergoing Coronary Artery Bypass Surgery. ANN THORAC SURG. 2022 Mai;113(5):1514-1520. https://doi.org/10.1016/j.athoracsur.2021.05.018

Bibtex

@article{e1fb1b8b4eb941b99f100ea670704918,
title = "Neurological Complications in High-Risk Patients Undergoing Coronary Artery Bypass Surgery",
abstract = "BACKGROUND: Coronary artery bypass grafting (CABG) without cardiopulmonary bypass and minimal or no aortic manipulation may be associated with a lower risk of neurological complications. We investigated this issue in patients with a high risk of perioperative stroke.METHODS: Data on 7352 patients who underwent isolated CABG from January 2015 to May 2017 were included in the multicenter study E-CABG (European Coronary Artery Bypass Grafting) registry. Of these, 684 patients had an increased risk of neurological complications, ie, previous stroke or transient ischemic attack, severe carotid artery stenosis or occlusion, or previous carotid artery intervention. In this subgroup, we analyzed the rates of the combined primary endpoint comprising any postoperative stroke or transient ischemic attack. A comparative analysis between CABG with and without aortic cross-clamping was performed.RESULTS: The primary endpoint was more often reached when aortic cross-clamping was used (propensity score matching, without vs with aortic cross-clamp: 0.9% vs 7.2%; P = .016). In comparison with all other revascularization techniques, off-pump CABG with avoidance of aortic manipulation was associated with the lowest rate of neurological complications (0.7%).CONCLUSIONS: In patients with increased risk of perioperative stroke, aortic manipulation including the use of cardiopulmonary bypass or partial clamping for central anastomoses is associated with higher rates of postoperative neurological complications. These patients may benefit from off-pump surgery without aortic manipulation if complete revascularization can be ensured.",
author = "Shiho Naito and Demal, {Till J} and Bj{\"o}rn Sill and Hermann Reichenspurner and Francesco Onorati and Giuseppe Gatti and Giovanni Mariscalco and Giuseppe Faggian and Francesco Santini and Giuseppe Santarpino and Marco Zanobini and Francesco Musumeci and Rubino, {Antonino S} and {De Feo}, Marisa and Francesco Nicolini and Magnus Dal{\'e}n and Daniele Maselli and Karl Bounader and Timo M{\"a}kikallio and Tatu Juvonen and Ruggieri, {Vito G} and Andrea Perrotti and Fausto Biancari",
note = "Copyright {\textcopyright} 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.",
year = "2022",
month = may,
doi = "10.1016/j.athoracsur.2021.05.018",
language = "English",
volume = "113",
pages = "1514--1520",
journal = "ANN THORAC SURG",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "5",

}

RIS

TY - JOUR

T1 - Neurological Complications in High-Risk Patients Undergoing Coronary Artery Bypass Surgery

AU - Naito, Shiho

AU - Demal, Till J

AU - Sill, Björn

AU - Reichenspurner, Hermann

AU - Onorati, Francesco

AU - Gatti, Giuseppe

AU - Mariscalco, Giovanni

AU - Faggian, Giuseppe

AU - Santini, Francesco

AU - Santarpino, Giuseppe

AU - Zanobini, Marco

AU - Musumeci, Francesco

AU - Rubino, Antonino S

AU - De Feo, Marisa

AU - Nicolini, Francesco

AU - Dalén, Magnus

AU - Maselli, Daniele

AU - Bounader, Karl

AU - Mäkikallio, Timo

AU - Juvonen, Tatu

AU - Ruggieri, Vito G

AU - Perrotti, Andrea

AU - Biancari, Fausto

N1 - Copyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

PY - 2022/5

Y1 - 2022/5

N2 - BACKGROUND: Coronary artery bypass grafting (CABG) without cardiopulmonary bypass and minimal or no aortic manipulation may be associated with a lower risk of neurological complications. We investigated this issue in patients with a high risk of perioperative stroke.METHODS: Data on 7352 patients who underwent isolated CABG from January 2015 to May 2017 were included in the multicenter study E-CABG (European Coronary Artery Bypass Grafting) registry. Of these, 684 patients had an increased risk of neurological complications, ie, previous stroke or transient ischemic attack, severe carotid artery stenosis or occlusion, or previous carotid artery intervention. In this subgroup, we analyzed the rates of the combined primary endpoint comprising any postoperative stroke or transient ischemic attack. A comparative analysis between CABG with and without aortic cross-clamping was performed.RESULTS: The primary endpoint was more often reached when aortic cross-clamping was used (propensity score matching, without vs with aortic cross-clamp: 0.9% vs 7.2%; P = .016). In comparison with all other revascularization techniques, off-pump CABG with avoidance of aortic manipulation was associated with the lowest rate of neurological complications (0.7%).CONCLUSIONS: In patients with increased risk of perioperative stroke, aortic manipulation including the use of cardiopulmonary bypass or partial clamping for central anastomoses is associated with higher rates of postoperative neurological complications. These patients may benefit from off-pump surgery without aortic manipulation if complete revascularization can be ensured.

AB - BACKGROUND: Coronary artery bypass grafting (CABG) without cardiopulmonary bypass and minimal or no aortic manipulation may be associated with a lower risk of neurological complications. We investigated this issue in patients with a high risk of perioperative stroke.METHODS: Data on 7352 patients who underwent isolated CABG from January 2015 to May 2017 were included in the multicenter study E-CABG (European Coronary Artery Bypass Grafting) registry. Of these, 684 patients had an increased risk of neurological complications, ie, previous stroke or transient ischemic attack, severe carotid artery stenosis or occlusion, or previous carotid artery intervention. In this subgroup, we analyzed the rates of the combined primary endpoint comprising any postoperative stroke or transient ischemic attack. A comparative analysis between CABG with and without aortic cross-clamping was performed.RESULTS: The primary endpoint was more often reached when aortic cross-clamping was used (propensity score matching, without vs with aortic cross-clamp: 0.9% vs 7.2%; P = .016). In comparison with all other revascularization techniques, off-pump CABG with avoidance of aortic manipulation was associated with the lowest rate of neurological complications (0.7%).CONCLUSIONS: In patients with increased risk of perioperative stroke, aortic manipulation including the use of cardiopulmonary bypass or partial clamping for central anastomoses is associated with higher rates of postoperative neurological complications. These patients may benefit from off-pump surgery without aortic manipulation if complete revascularization can be ensured.

U2 - 10.1016/j.athoracsur.2021.05.018

DO - 10.1016/j.athoracsur.2021.05.018

M3 - SCORING: Journal article

C2 - 34087237

VL - 113

SP - 1514

EP - 1520

JO - ANN THORAC SURG

JF - ANN THORAC SURG

SN - 0003-4975

IS - 5

ER -