Off-pump coronary surgery: An updated systematic review and meta-analysis

被引：2

作者：

Angeles Tena, Maria ^{[1
]}

Urso, Stefano ^{[1
]}

Manuel Martinez-Comendador, Jose ^{[2
]}

Bellot, Raquel ^{[1
]}

Martin Gutierrez, Elio ^{[2
]}

Maria Gonzalez, Jesus ^{[3
]}

Sadaba, Rafael ^{[4
]}

Meca, Juan ^{[5
]}

Rios, Luis ^{[1
]}

Abad, Cipriano ^{[1
]}

Portela, Francisco ^{[1
]}

机构：

[1] Hosp Univ Dr Negrin, Serv Cirugia Cardiaca, Las Palmas Gran Canaria, Las Palmas, Spain

[2] Hosp Univ Leon, Serv Cirugia Cardiaca, Leon, Spain

[3] Hosp Univ Dr Negrin, Unidad Invest, Las Palmas Gran Canaria, Las Palmas, Spain

[4] Complejo Hosp Navarra, Serv Cirugia Cardiaca, Navarra, Spain

[5] Hosp La Paz, Serv Cirugia Cardiaca, Madrid, Spain

来源：

CIRUGIA CARDIOVASCULAR | 2019年 / 26卷 / 02期

关键词：

Meta analysis; Systematic review; Off-pump; Coronary artery bypass grafting; Graft patency; ARTERY-BYPASS SURGERY; TERM-FOLLOW-UP; SIMILAR GRAFT PATENCY; DANISH ON-PUMP; RANDOMIZED-TRIALS; RISK PATIENTS; MYOCARDIAL REVASCULARIZATION; 5-YEAR OUTCOMES; ASCENDING AORTA; LIFE OUTCOMES;

D O I：

10.1016/j.circv.2018.12.001

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Introduction and objectives: After 30 years, off-pump coronary artery bypass grafting benefits are still controversial when compared with the on-pump technique. For this reason, a meta-analysis is presented that compares the early and long-term results of the 2 surgical strategies. Methods: A search was made of PubMed, EMBASE, and the Cochrane library database for clinical trials up to December 2017 for randomised clinical trials investigating off-pump versus on-pump coronary surgery with sample size of >= 100 patients. Results: A total of 34 clinical trials, with a total of 16,435 patients and 9643 examined grafts were included in this meta-analysis. Off-pump surgery achieved similar 30-day and 1-year mortality compared with on-pump surgery. The off-pump technique significantly decreased the risk of 30-day stroke (RR 0.73; 95% CI; 0.57-0.94; p=0.015), but it increases 1-year repeat revascularization risk (RR 1.52; 95% CI; 1.18-1.96; p=0.001), 5-year mortality risk (RR= 1.15; 95% CI; 1.03-1.29; p=0.012) and it is associated with worse graft patency (RR 0.97; 95% CI; 0.94-0.99; p=0.007) compared with on-pump surgery. Conclusions: Off-pump coronary surgery may provide better short-term neurological results compared with the on-pump technique, at the expense of a worse graft patency, increased risk of 1-year repeat revascularisation, and of 5-years mortality. (C) 2019 Sociedad Espanola de Cirugia Toracica-Cardiovascular. Published by Elsevier Espana, S.L.U.

引用

页码：81 / 91

页数：11