Clinical outcomes of automated anastomotic devices: A metanalysis

Linda Renata Micali, Francesco Matteucci, Orlando Parise, Cecilia Tetta, Amalia Ioanna Moula, Monique de Jong, Francesco Londero, Sandro Gelsomino*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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; I-2 = 72.907%, P = .002; Egger's test: intercept = -2.47, P = 0.16; Begg and Mazumdar test: tau = -0.20, p = 0.57). Graft patency was 90.5% (80.4 to 95.7, P <.001; I-2 = 76.823%, P = .005; Egger's test: intercept = -3.04, P = .10; Begg and Mazumdar test: tau = -0.67, P = .17). Furthermore, the overall incidence of MACEs was 3.7% (1.3-10.4, P <.001; I-2 = 51.556%, P = .103; Egger's test: intercept = -1.98, P = <.11; Begg and Mazumdar test: tau = -0.67, P = .17). Finally, mortality within 1 year was 5% (3.5-7, P <.001; I-2 = 29.675%, P = .202; Egger's test: intercept = -0.91, P = .62; Begg and Mazumdar test: tau = -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.

Original languageEnglish
Pages (from-to)1297-1304
Number of pages8
JournalJournal of Cardiac Surgery
Volume34
Issue number11
DOIs
Publication statusPublished - Nov 2019

Keywords

  • coronary artery bypass grafting
  • coronary artery disease
  • proximal anastomoses
  • ARTERY-BYPASS SURGERY
  • AORTIC MANIPULATION
  • NEUROLOGICAL COMPLICATIONS
  • PROXIMAL ANASTOMOSIS
  • PATENCY RATE
  • FOLLOW-UP
  • CORONARY
  • GRAFT
  • SYSTEM
  • IMPACT

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