The Annals of thoracic surgery
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Review Meta Analysis Comparative Study
Effect of skeletonization of the internal thoracic artery for coronary revascularization on the incidence of sternal wound infection.
Use of the internal thoracic artery in coronary revascularization confers excellent benefit. We assessed the impact of skeletonization on the incidence of postoperative sternal wound infection in patients undergoing coronary artery bypass grafting. ⋯ Skeletonization was associated with beneficial reduction in the odds ratio of sternal wound infection (odds ratio, 0.41; 95% confidence interval, 0.26 to 0.64). This effect was more evident when analyzing diabetic patients undergoing bilateral internal thoracic artery grafting (odds ratio, 0.19; 95% confidence interval, 0.10 to 0.34).
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Review Meta Analysis
A systematic review of biocompatible cardiopulmonary bypass circuits and clinical outcome.
This systematic review and meta-analysis explores the clinical efficacy of biocompatible surfaces for cardiopulmonary bypass in adults. Thirty-six randomized controlled trials were retrieved for a total of 4360 patients. ⋯ When the analysis was limited to high-quality studies, only a reduction in atrial fibrillation rate and a shorter stay in the intensive care unit remained significantly associated with the use of biocompatible surfaces. Using biocompatible surfaces without other measures to contain blood activation results in a limited clinical benefit.
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There is no agreement whether off-pump coronary artery bypass (OPCAB) can reduce mortality, rates of stroke, myocardial infarction, or revascularization when compared with conventional coronary artery bypass (CCAB). We performed a meta-analysis comparing off-pump coronary artery bypass with conventional coronary artery bypass in randomized controlled trials. ⋯ In conclusion, OPCAB did not significantly reduce 1-year mortality, stroke, myocardial infarction, and revascularization compared with CCAB.
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Review Meta Analysis
N-acetylcysteine in cardiovascular-surgery-associated renal failure: a meta-analysis.
Clinical trials with N-acetylcysteine (NAC) in perioperative cardiovascular settings have shown inconsistent effects for renal endpoints. We aimed to systematically review these trials to ascertain its role in prevention of post-cardiovascular surgery acute renal failure. ⋯ Overall analysis of the existent literature shows that NAC is not beneficial in the prevention of post-cardiovascular surgery renal dysfunction. Routine use of NAC for this indication should be avoided.
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Comment Letter Meta Analysis
Neurocognitive decline after off-pump versus on-pump coronary artery bypass.