The off-pump coronary artery bypass grafting has favorable effect on neurological causes of mortality

Sep 29, 2026

Background: This study evaluates the effect of off-pump coronary artery bypass grafting on neurological causes of mortality. Methods: From November 1, 2014 to December 31, 2022, 1,154 off-pump CABG patients were retrospectively analyzed, recording demographics, comorbidities, perioperative status, and postoperative clinical outcomes; survival analysis was performed. Results: Perioperative stroke occurred in five (0.4%) patients. One-year, three-year, and five-year survival rates were 98.7%, 97.4%, and 96.5%. Conclusion: Avoiding aortic manipulation during off-pump CABG may reduce adverse neurological effects.

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Turkish Journal of Thoracic and Cardiovascular Surgery 2025;33(4):423-431 Orıgınal Artıcle / Özgün Makale The off-pump coronary artery bypass grafting has favorable effect on neurological causes of mortality Çalışan kalpte koroner arter baypas cer rahisinin nörolojik mortaliteye olumlu etkileri Zümrüt Tuba Demirözü1􀀬, Eray Aksoy2􀀬, Sami Gürkahraman2􀀬, Mehmet Şanser Ateş1􀀬 Institution where the research was done: Vehbi Koç Foundation American Hospital, Istanbul, Türkiye Koç University School of Medicine, İstanbul, Türkiye Author Affiliations: 1Department of Cardiovascular Surgery, Koç University School of Medicine, İstanbul, Türkiye 2Department of Cardiovascular Surgery, Vehbi Koç Foundation American Hospital, Istanbul, Türkiye ABSTRACT Background: This study aims to evaluate the effect of off-pump coronary artery bypass grafting on neurological causes of mortality. Methods: Between November 1st , 2014 and December 31st , 2022, a total of 1,154 off-pump coronary artery bypass grafting patients (963 males, 191 females; mean age: 64±10.9 years; range, 13 to 95 years) were retrospectively analyzed. Demographic characteristics, preexisting comorbidities, perioperative status, and postoperative clinical outcomes of the patients were recorded. Survival analysis was carried out. Results: No-touch aorta coronary artery bypass grafting was performed 958 (83%) patients and single side-biting clamp was used in 196 (17%) patients. Two-hundred seventy-one (23.5%) patients were in an emergent condition, and 63 (5.5%) patients hada history of stroke and/or transient ischemic attack preoperatively. Concomitant carotid endarterectomy was performed in 50 (4.3%) patients. Postoperatively, 139 (12%) patients had atrial fibrillation and five (0.4%) patients had stroke. Seven patients (0.6%) died in the hospital and one (0.08%) patient died in the postoperative 30-day period. One-year, three-year, and five-year survival rates were 98.7%, 97.4%, and 96.5%, respectively. Conclusion: Off-pump coronary artery bypass grafting is associated with a low incidence of perioperative stroke. Avoidance of aortic manipulation in off-pump coronary artery bypass grafting may reduce the risk of adverse neurological effects of cardiopulmonary bypass. We attribute the long-term survival to shorter lengths of stay in the intensive care unit and hospital and less need for blood products after surgery. Keywords: Internal mammary artery, off-pump coronary artery bypass grafting, radial artery, stroke. ÖZ Amaç: Bu çalışmada çalışan kalpte koroner arter baypas greftlemenin mortalitenin nörolojik nedenleri üzerine etkisideğerlendirildi. Çalışmaplanı: 01Kasım 2014-31 Aralık 2022 tarihleri arasında çalışan kalpte koroner arter baypas greftleme yapılan toplam 1154 hasta (963 erkek, 191 kadın; ort . yaş: 64±10.9 yıl; dağılım, 13-95 yıl) retrospektif olarak incelendi. Hastaların demografik özellikleri, mevcut eşlik eden hastalıkları, perioperatif durum ve ameliyat sonrası klinik sonuçlar kaydedildi. Sağkalımanalizi yapıldı . Bulgular: Aortaya dokunulmadan koroner arter baypas greftleme 958 (%83) hastada ve aorta üzerine tek taraflı ısırmaklempi 196 (%17) hastada uygulandı . Ameliyat öncesi dönemde 271 (%23.5) hasta acil koşullarda ve 63 (%5.5) hastada ise inmeve/veya geçici iskemik atak öyküsü vardı . Elli (%4.3) hastadaeş zamanlı karotis endarterktomi yapıldı . Ameliyat sonrası dönemde 139 (%12) hastada atriyal fibrilasyon ve beş (%0.4) hastada inme tespit edildi. Yedi (%0.6) hasta hastanede ve bir (%0.08) hasta ameliyat sonrası 30 günlük dönemde kaybedildi. Bir yıllık, üç yıllık ve beş yıllık sağkalım oranları sırasıyla %98 .7,%97 .4 ve %96 .5 idi. Sonuç: Koroner arter baypas greftleme düşük perioperatif inmeinsidansı ile ilişkilidir. Çalışan kalpte koroner arter baypas greftlemede aort manipülasyonundan kaçınılması, kardiyopulmoner baypasın olumsuz nörolojik etkilerinin riskini azaltabilir. Uzundönem sağkalım oranlarımız, yoğun bakım v

FAQs

What was the main purpose of the study?

To evaluate how off-pump coronary artery bypass grafting affects neurological causes of mortality.

How many patients were included and how was the study conducted?

A total of 1,154 patients undergoing off-pump coronary artery bypass grafting were retrospectively analyzed from November 1, 2014 to December 31, 2022, with survival analysis performed.

What postoperative neurological outcomes were reported?

Postoperatively, 139 (12%) patients had atrial fibrillation and five (0.4%) patients had stroke, with very low in-hospital and 30-day mortality.

Sep 29, 2026

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