Introduction: The procedure called the "aorta no-touch" (NT) or anaortic technique in off-pump coronary artery bypass grafting (OPCAB) is designed to reduce the perioperative risk of stroke. We have observed an increased frequency of anaortic OPCAB procedures at our institution. The main purpose of the present study is to investigate the effectiveness of anaortic OPCAB in reducing the perioperative risk of stroke.
Methods: From April 2011 to July 2023, a total of 2,236 patients underwent isolated OPCAB at our single center. The patients were divided into the anaortic group (NT, = 762) and the aortic group (A, = 1,474). The NT group was propensity score-matched (PSM) with the A group at a 1:1 ratio (NT = 640; A = 640), and matching was performed based on 26 covariates with preoperative clinical characteristics.
Results: In both the unmatched and matched cohorts of the NT and A groups, there were no significant differences observed in new stroke rates (NT vs. A; unmatched, 1.0% vs. 1.2%, = 0.624; matched, 0.9% vs. 1.3%, = 0.789). The univariable logistic analysis did not identify the anaortic technique as an independent factor negatively associated with new stroke events (OR = 0.81, 95% CI = 0.35-1.86, = 0.624).
Conclusion: The present study did not find the anaortic technique to reduce the perioperative risk of stroke in OPCAB. Hence, further large studies are needed to identify patient cohorts in which anaortic OPCAB is significantly beneficial.
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http://dx.doi.org/10.3389/fcvm.2024.1393921 | DOI Listing |
J Chest Surg
January 2025
Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Background: This study presents an overview of our technique and the perioperative outcomes for the first 100 patients who underwent minimally invasive endoscopic-assisted off-pump multivessel bypass grafting (endoscopic coronary artery bypass [endo-CAB]) at the Catharina Hospital in Eindhoven.
Methods: The first 100 patients undergoing multivessel endo-CAB from May 2022 to March 2024 were included in this retrospective, single-center, observational study (N=100). The study encompassed both elective and urgent surgical revascularization.
Front Cardiovasc Med
October 2024
Department of Cardiothoracic Surgery, Medical School of the National and Kapodistrian University, Athens, Greece.
Background: Since 2000, we have been grafting the right coronary artery system (RCAs) using the proximal portion of the right internal thoracic artery (RITA) as the inflow of the saphenous vein graft (SVG) to increase the number of patients undergoing beating heart complete myocardial revascularization.
Methods: From 2000 to 2022, 928 consecutive patients underwent SVG on the RCAs. In 546 patients (58.
Heart Lung Circ
September 2024
Department of Cardiothoracic Surgery, St George Hospital, Kogarah, NSW, Australia; Department of Cardiothoracic Surgery, Macquarie University Hospital, Macquarie University, NSW, Australia.
Background: Routine screening chest computed tomography (CT) prior to primary cardiac surgery is advocated by some surgeons due to the purported benefits of identifying significant aortic calcification that impacts ongoing management, such as performing anaortic off-pump surgery or adjusting cannulation strategy. Additionally, axial imaging can identify incidental findings that may require concomitant or staged procedures such as ascending aortic dilatation or pulmonary lesions. The objective of this study was to quantify the impact that nonselective chest CT prior to primary cardiac surgery had on subsequent management.
View Article and Find Full Text PDFEur J Cardiothorac Surg
July 2024
Department of Cardiovascular Surgery, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Front Cardiovasc Med
May 2024
Cardiovascular and Thoracic Surgery Unit, Department of Surgery, Lampang Hospital, Lampang, Thailand.
Introduction: The procedure called the "aorta no-touch" (NT) or anaortic technique in off-pump coronary artery bypass grafting (OPCAB) is designed to reduce the perioperative risk of stroke. We have observed an increased frequency of anaortic OPCAB procedures at our institution. The main purpose of the present study is to investigate the effectiveness of anaortic OPCAB in reducing the perioperative risk of stroke.
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