title: Coronary artery bypass grafting with and without manipulation of the ascending aorta--a meta-analysis.
abstract: BACKGROUND
  The main criticism of surgery in the SYNTAX trial was increased rate of stroke when compared to percutaneous coronary intervention. We aimed to determine whether avoiding aortic manipulation would decrease the rate of stroke.
  
  
  METHODS
  We performed a meta-analysis of seven studies comparing coronary artery bypass grafting (CABG) with and without manipulation of the ascending aorta.
  
  
  RESULTS
  When anaortic off-pump coronary artery bypass grafting (OPCAB) was compared with conventional CABG, the rate of stroke was 0.38% vs. 1.87% (p<0.0001). When anaortic OPCAB was compared with OPCAB using a side-clamp or proximal graft anastomosis device the rate of stroke was 0.31% vs. 1.35% (p=0.003).
  
  
  CONCLUSIONS
  Avoiding aortic manipulation during CABG may decrease the rate of peri-operative stroke.
authors.affiliation: Cardiothoracic Surgical Unit, Royal Prince Alfred Hospital, Sydney, Australia. jjbedelman@gmail.com
authors.forename: J James
authors.initials: JJ
authors.lastname: Edelman
authors.forename: Tristan D
authors.initials: TD
authors.lastname: Yan
authors.forename: Paul G
authors.initials: PG
authors.lastname: Bannon
authors.forename: Michael K
authors.initials: MK
authors.lastname: Wilson
authors.forename: Michael P
authors.initials: MP
authors.lastname: Vallely
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001011:Aorta; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control