Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Nov;34(11):1297-1304.
doi: 10.1111/jocs.14186. Epub 2019 Aug 31.

Clinical outcomes of automated anastomotic devices: A metanalysis

Linda Renata Micali  1 , Francesco Matteucci  1 , Orlando Parise  1 , Cecilia Tetta  1 , Amalia Ioanna Moula  1 , Monique de Jong  1 , Francesco Londero  1 , Sandro Gelsomino  1
Affiliations
Meta-Analysis

Clinical outcomes of automated anastomotic devices: A metanalysis

Linda Renata Micali et al. J Card Surg. 2019 Nov.

Abstract

Background and aims: We investigated neurological events, graft patency, major adverse cardiovascular events (MACEs), and mortality at 1 year following coronary artery bypass grafting (CABG) surgery using automated proximal anastomotic devices (APADs) and compared the overall rates with the current literature.

Methods: A systematic review of all available reports of APADs use in the literature was conducted. Cumulative incidence and 95% confidence interval (CI) were the main statistical indexes. Nine observational studies encompassing a total of 718 patients were included at the end of the selection process.

Results: The cumulative event rate of neurological complications was 4.8% (lower-upper limits: 2.8-8.0, P < .001; I2 = 72.907%, P = .002; Egger's test: intercept = -2.47, P = 0.16; Begg and Mazumdar test: τ = -0.20, p = 0.57). Graft patency was 90.5% (80.4 to 95.7, P < .001; I2 = 76.823%, P = .005; Egger's test: intercept = -3.04, P = .10; Begg and Mazumdar test: τ = -0.67, P = .17). Furthermore, the overall incidence of MACEs was 3.7% (1.3-10.4, P < .001; I2 = 51.556%, P = .103; Egger's test: intercept = -1.98, P = < .11; Begg and Mazumdar test: τ = -0.67, P = .17). Finally, mortality within 1 year was 5% (3.5-7, P < .001; I2 = 29.675%, P = .202; Egger's test: intercept = -0.91, P = .62; Begg and Mazumdar test: τ = -0.04, P = .88).

Conclusions: APADs do not seem to be correlated with a reduction of either neurological events or mortality. By contrast, these tools showed satisfactory one-year graft patency and a low incidence of MACEs. Further research on this topic is warranted.

Keywords: coronary artery bypass grafting; coronary artery disease; proximal anastomoses.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the selection process
Figure 2
Figure 2
Forest plot event rates of the main endpoints. A, Neurological events. B, Graft patency. C, Major adverse cardiovascular events (MACEs). D, Mortality
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. McDonagh DL, Berger M, Mathew JP, Graffagnino C, Milano CA, Newman MF. Neurological complications of cardiac surgery. Lancet Neurol. 2014;13(5):490‐502. - PMC - PubMed
    1. Palmerini T, Savini C, Di Eusanio M. Risks of stroke after coronary artery bypass graft ‐ recent insights and perspectives. Interv Cardiol (London, England). 2011;9(2):77‐83. - PMC - PubMed
    1. Calafiore AM, Di Mauro M, Teodori G, et al. Impact of aortic manipulation on incidence of cerebrovascular accidents after surgical myocardial revascularization. Ann Thorac Surg. 2002;73(5):1387‐1393. - PubMed
    1. Bassano C, Bovio E, Uva F, et al. Partially anaortic clampless off‐pump coronary artery bypass prevents neurologic injury compared to on‐pump coronary surgery: a propensity score‐matched study on 286 patients. Heart Vessels. 2016;31(9):1412‐1417. - PMC - PubMed
    1. Kapetanakis EI, Stamou SC, Dullum MKC, et al. The impact of aortic manipulation on neurologic outcomes after coronary artery bypass surgery: a risk‐adjusted study. Ann Thorac Surg. 2004;78(5):1564‐1571. - PubMed

Publication types