Minimally Invasive Extracorporeal Circulation Circuit Is Not Inferior to Off-Pump Coronary Artery Bypass Grafting: Meta-Analysis Using the Bayesian Method

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• 作者：Bernhard Winkler ; MD^a ; ^&lowast ; ; Paul P. Heinisch ; MD^a ; ^&lowast ; ; ^{ppheinisch@googlemail.com} ; Brigitta Gahl ; MSc^a ; Soheila Aghlmandi ; MSc^b ; Hans Jö ; rg Jenni ; EBCP^a ; Thierry P. Carrel ; MD ; PhD^a
• 关键词：AF ; atrial fibrillation ; CABG ; coronary artery bypass graft surgery ; CI ; confidence interval ; ICU ; intensive care unit ; MI ; myocardial infarction ; MiECT ; minimally invasive extracorporeal circulation technologies ; OPCABG ; off-pump coronary artery bypass grafting ; OR ; odds ratio ; RCT ; randomized clinical trial ; SMD ; standardized mean difference
• 刊名：The Annals of Thoracic Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：103
• 期：1
• 页码：342-350
• 全文大小：993 K
• 卷排序：103

文摘

The pathophysiologic side effects of cardiopulmonary bypass have already been identified. Minimally invasive extracorporeal circulation technologies (MiECT) and off-pump coronary artery bypass graft surgery (OPCABG) aim to reduce these problems. This meta-analysis provides a comparison of MiECT and OPCABG in randomized and observational studies. A fully probabilistic, Bayesian approach of primary and secondary endpoints was conducted. MiECT does not give inferior results when compared with OPCABG. However, there is a trend to borderline significantly higher blood loss in this group in randomized controlled trials. The question whether MiECT is equivalent to OPCABG can be answered with the affirmative, but long-term follow-up data are needed to detect any advantage over time.