Neurologic Complications Rate Following Aortic Manipulation after Off-Pump Coronary Artery Bypass Grafting: A Meta-Analysis

Background: Neurologic complications after coronary artery bypass grafting continue to be among the most devastating complications. The goal of coronary artery bypass grafting, which is performed utilizing off-pump techniques on a beating heart, was to reduce this risk. The purpose of the study was to assess the neurologic complications rate following aortic manipulation after off-pump coronary artery bypass grafting. Methods: Dichotomous random or fixed effect models generated the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) based on the study of the meta-analysis data. 28 papers, with a total of 823,972 patients, were available between 2002 and 2021 and were comprised in this meta-analysis. Results: Aortic manipulation was much less likely to cause a stroke in people with off-pump coronary artery bypass grafting (OR, 0.58; 95% CI, 0.44-0.77; p < 0.001) than non-aortic manipulation. However, no significant difference was found between aortic manipulation and non-aortic manipulation in all-cause mortality (OR, 0.84; 95% CI, 0.69-1.02, p = 0.08), acute renal failure (OR, 0.86; 95% CI, 0.69-1.08, p = 0.20), atrial fibrillation (OR, 0.67; 95% CI, 0.21-2.15, p = 0.50), myocardial infarction (OR, 0.75; 95% CI, 0.56-1.01, p = 0.06), respiratory complications (OR, 0.64; 95% CI, 0.40-1.03, p = 0.07), reoperation for bleeding (OR, 0.89; 95% CI, 0.57-1.38, p = 0.59), and mediastinitis (OR, 0.77; 95% CI, 0.46-1.28, p = 0.31) in subjects with off-pump coronary artery bypass grafting. Conclusions: The present evaluation showed that using aortic manipulation resulted in a significantly lower rate of stroke occurence; however, no significant difference was found in all-cause mortality, acute renal failure, atrial fibrillation, myocardial infarction, respiratory complications, reoperation for bleeding, and mediastinitis compared to non-aortic manipulation in subjects with off-pump coronary artery bypass grafting. However, given that some comparisons comprised a small number of studies, attention ought to be given to their values.