OBJECTIVE: To assess neurocognitive impairment after the off-pump and on-pump techniques for coronary artery bypass graft surgery in patients with triple vessel disease. DESIGN: Randomised controlled trial. SETTING:University Hospital of Wales, Cardiff. PARTICIPANTS: 60 patients undergoingcoronary artery bypass graft surgery for triple vessel disease prospectively randomised to the off-pump or on-pump technique. MAIN OUTCOME MEASURES: Change in scores in nine standard neuropsychometric tests administered preoperatively and at 1 and 10 weeks postoperatively. RESULTS: The on-pump group showed a significantly greater deterioration in scores for two and three tests at 1 week and 10 weeks postoperatively, respectively, than the off-pump group. The on-pump group also showed a significantly higher incidence of major deterioration in one of the tests both 1 week and 10 weeks postoperatively. The incidence of neurocognitive impairment at 1 week postoperatively was 27% (8 out of 30) in the off-pump group and 63% (19 out of 30) in the on-pump group (P=0.004); and at 10 weeks postoperatively was 10% (3 out of 30) in the off-pump group and 40% (12 out of 30) in the on-pump group (P=0.017). CONCLUSION:Off-pump coronary artery bypass graft surgery results in less neurocognitive impairment than the on-pump technique.
RCT Entities:
OBJECTIVE: To assess neurocognitive impairment after the off-pump and on-pump techniques for coronary artery bypass graft surgery in patients with triple vessel disease. DESIGN: Randomised controlled trial. SETTING: University Hospital of Wales, Cardiff. PARTICIPANTS: 60 patients undergoing coronary artery bypass graft surgery for triple vessel disease prospectively randomised to the off-pump or on-pump technique. MAIN OUTCOME MEASURES: Change in scores in nine standard neuropsychometric tests administered preoperatively and at 1 and 10 weeks postoperatively. RESULTS: The on-pump group showed a significantly greater deterioration in scores for two and three tests at 1 week and 10 weeks postoperatively, respectively, than the off-pump group. The on-pump group also showed a significantly higher incidence of major deterioration in one of the tests both 1 week and 10 weeks postoperatively. The incidence of neurocognitive impairment at 1 week postoperatively was 27% (8 out of 30) in the off-pump group and 63% (19 out of 30) in the on-pump group (P=0.004); and at 10 weeks postoperatively was 10% (3 out of 30) in the off-pump group and 40% (12 out of 30) in the on-pump group (P=0.017). CONCLUSION: Off-pump coronary artery bypass graft surgery results in less neurocognitive impairment than the on-pump technique.
Authors: M F Newman; J L Kirchner; B Phillips-Bute; V Gaver; H Grocott; R H Jones; D B Mark; J G Reves; J A Blumenthal Journal: N Engl J Med Date: 2001-02-08 Impact factor: 91.245
Authors: Diederik Van Dijk; Erik W L Jansen; Ron Hijman; Arno P Nierich; Jan C Diephuis; Karel G M Moons; Jaap R Lahpor; Cornelius Borst; Annemieke M A Keizer; Hendrik M Nathoe; Diederick E Grobbee; Peter P T De Jaegere; Cor J Kalkman Journal: JAMA Date: 2002-03-20 Impact factor: 56.272
Authors: S Westaby; K Saatvedt; S White; T Katsumata; W van Oeveren; N K Bhatnagar; S Brown; P W Halligan Journal: J Thorac Cardiovasc Surg Date: 2000-01 Impact factor: 5.209
Authors: James C Jackson; Sharon M Gordon; E Wesley Ely; Candice Burger; Ramona O Hopkins Journal: Intensive Care Med Date: 2004-09-15 Impact factor: 17.440