Objective: Higher-than-predicted occurrence of neurological events (NE) has been documented in surgical-arm Syntax study patients. Multiple aortic clamping has been implicated. We aimed to determine the incidence of NE following single cross-clamp coronary artery bypass grafting (CABG) avoiding partial clamping.
Methods: Between January 2006 and August 2011, 914 consecutive on-pump bilateral internal thoracic artery grafting patients underwent single cross-clamp isolated CABG. NE were defined as permanent or transient events occurring within 30-day postoperatively. Distal and proximal anastomoses were performed during single clamping and partial clamping was invariably avoided.
Results: Mean patients' age was 59.6±8.8 years (range, 35-88). Septuagenarians and octogenarians comprised 13.5% and 1%, respectively. Grafts/patient ratio was 3.2±1.5 and proximal aortic anastomoses were performed in 27.5% of the patients (mean0.44±0.52, range 0-2). Overall permanent NE rate was 0.77% (7/914). Stroke-related mortality was 14% (1/7). The respective rate of immediate (at awakening) and delayed stroke was 57 % (4/7) and 42% (3/7), respectively (p=NS).
Conclusions: Carefully Single cross-clamp with minimal aortic manipulation can reduce stroke rate even to the range of the PCI group In the SYNTAX trial (0.6% Vs 0.77%), without any adverse effect on myocardial protection and postoperative outcome in patients undergoing CABG.
