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J Thorac Cardiovasc Surg 2007;134:512-513
© 2007 The American Association for Thoracic Surgery

Brief Communication

Cognitive decline after off-pump versus on-pump coronary artery bypass graft surgery: Meta-analysis of randomized controlled trials

Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.

Received for publication March 25, 2007; accepted for publication April 19, 2007.

^_* Address for reprints: Hisato Takagi, MD, PhD, Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka 411-8611, Japan. (Email: kfgth973@ybb.ne.jp).

The first 20% of the full text of this article appears below.

In the randomized Octopus Study that compared off-pump with on-pump coronary artery bypass graft (CABG) surgery, van Dijk and associates¹ found that avoiding the use of cardiopulmonary bypass had no effect on 5-year cognitive outcomes. On the other hand, in the same trial, off-pump CABG surgery resulted in a trend toward better cognitive outcomes 3 months after the procedure, but the effect became negligible at 12 months.² Although the meta-analysis by Cheng and colleagues³ of 37 randomized trials showed significantly reduced neurocognitive decline at 2 to 6 months (number of trials [N] = 3), significant reductions were not found at 1 month (N = 3) or 12 months (N = 2). Inasmuch as only 4 studies that met their inclusion criteria contributed data to this outcome at any time point, however, the results are not inclusive enough to rule out clinically important differences.³ . . . [Full Text of this Article]

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