Off-pump coronary bypass operations significantly reduce S100 release: an indicator for less cerebral damage?

Wandschneider, W.; Thalmann, Markus; Trampitsch, Ernst; Ziervogel, Gertrud; Kobinia, G

doi:10.1016/s0003-4975(00)01843-9

Cited by 61 publications

(41 citation statements)

References 17 publications

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“…In their report, Wandschneider et al [22] omit 11 patients from their analysis that crossed-over after randomisation from OPCAB to CABG. We included these in our analysis.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis on the effect of off-pump coronary bypass surgery1

Heijden

Nathoe

Jansen

et al. 2004

European Journal of Cardio-Thoracic Surgery

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“…In their report, Wandschneider et al [22] omit 11 patients from their analysis that crossed-over after randomisation from OPCAB to CABG. We included these in our analysis.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis on the effect of off-pump coronary bypass surgery1

Heijden

Nathoe

Jansen

et al. 2004

European Journal of Cardio-Thoracic Surgery

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“…[17][18][19][20][21][22] One of the most important predictors of stroke after cardiac surgery is manipulation of the ascending thoracic aorta which may be atherosclerotic. 23,24 Off-pump surgery has a potential to reduce the need for aortic manipulation and there is evidence that off-pump CABG is associated with substantially reduced levels of S-100 protein (indicative of minor or major brain injury) [25][26][27] and reduced microembolic release 27-29 as compared with on-pump CABG.…”

Section: Discussionmentioning

confidence: 99%

Off-Pump Surgery Is Associated With Reduced Occurrence of Stroke and Other Morbidity as Compared With Traditional Coronary Artery Bypass Grafting

Sedrakyan

Parashar

et al. 2006

Stroke

175

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Background and Purpose-There is growing enthusiasm for coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB). Although deleterious effects of CPB are known, it remains to be proven that avoiding CPB will result in reduction in morbidity. We sought to determine whether off-pump surgery is associated with reduced occurrence of adverse outcomes as compared with CABG with CPB. Methods-Studies were identified by searching the MEDLINE, EMBASE and the Cochrane Register 1980. We also searched the reference lists of randomized clinical trials (RCT) and reviews to look for additional studies. Study selection: RCTs comparing off-pump surgery to CABG with CPB. No restriction applied on the size of the trial or end point reports. Data extraction: 2 reviewers independently searched for studies, read abstracts and abstracted all data. Data synthesis: combined estimates were obtained using fixed or random effect meta-analyses. Relative risks and risk differences were calculated. Heterogeneity was assessed using 2 and I 2 values. Results-There were 3996 patients enrolled in 41 RCTs (mean age 62, 22% female). No study reported information on race. Off-pump CABG was associated with a 50% reduction in the relative risk of stroke (95% CI, 7% to 73%), 30% reduction in atrial fibrillation (AF; 95% CI, 16% to 43%) and 48% reduction in wound infection (95% CI, 26% to 63%) with no heterogeneity among RCTs. This translated into avoidance of 10 strokes, 80 cases of AF and 40 infections per 1000 CABG. Fewer distal grafts were performed and there was evidence for Ͼ10 reinterventions per 1000 with off-pump CABG. Long-term follow-up is not yet reported in the trials. Conclusions-Off-pump CABG is associated with reduced risk of stroke, AF and infections as compared with CABG with CPB. Evidence should be generalized taking into account RCT enrollment limitations, drawbacks related to training requirements, propensity to perform fewer grafts and likely reinterventions after off-pump surgery. (Stroke. 2006;37: 2759-2769.)

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“…Prolonged mechanical ventilation and increased the number of bypassed coronary arteries also contributed to impaired verbal memory and deteriorated cerebral blood perfusion (16). Perioperative cerebral impairment can be reduced in cardiac operations without the use of CPB, for example, in offpump coronary artery bypass (20). Thus, many studies have focused on the evaluation of biomarkers of cerebral injury between off-pump versus on-pump.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers of cerebral injury in cardiac surgery

Yuan¹

2014

Anadolu Kardiyol Derg

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The present study aims to reveal the changing patterns of cerebral biomarkers and the underlying predictive factors as a consequence of cardiac surgery. Literature retrieval of articles on S100 and S100B of recent 20 years were made in the MEDLINE database, Highwire Press and Google search. Quantitative data of S100 and S100B along with neuron-specific enolase were carefully screened, collected and statistically analyzed. The biomarkers appeared earlier and lasted longer in the cerebrospinal fluid than in the serum. All three biomarkers exhibited a similar kinetic trend in the bloodstream, reaching a peak value at the end of cardiopulmonary bypass (CPB). In adults, serum biomarkers may recover to normal earlier than in pediatrics undergoing a cardiac surgery. The patients undergoing off-pump surgery had the minimal elevations of cerebral biomarkers comparing to all other cardiac surgeries under CPB, low core temperature and/or hypothermic circulatory arrest. In patients with pre-or postoperative neurological disorders, the biomarkers in the serum elevated even before operation and persisted longer time than those without neurological disorders. The serum concentrations of the biomarkers showed direct correlation with CPB duration and core temperature. Cardiac operations may lead to cerebral damage and blood-brain barrier changes, as a consequence of CPB and low core temperature. The cerebral biomarkers including S100, S100B and neuron-specific enolase may precisely reflect the cerebral damages in cardiac surgery. Attention has to be paid to the attenuations of cerebral damage by modifying the surgical conditions of CPB and core temperature.

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Off-pump coronary bypass operations significantly reduce S100 release: an indicator for less cerebral damage?

Cited by 61 publications

References 17 publications

Meta-analysis on the effect of off-pump coronary bypass surgery1

Meta-analysis on the effect of off-pump coronary bypass surgery1

Off-Pump Surgery Is Associated With Reduced Occurrence of Stroke and Other Morbidity as Compared With Traditional Coronary Artery Bypass Grafting

Biomarkers of cerebral injury in cardiac surgery

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