TY - JOUR
T1 - Clinical outcomes of automated anastomotic devices
T2 - A metanalysis
AU - Micali, Linda Renata
AU - Matteucci, Francesco
AU - Parise, Orlando
AU - Tetta, Cecilia
AU - Moula, Amalia Ioanna
AU - de Jong, Monique
AU - Londero, Francesco
AU - Gelsomino, Sandro
N1 - Funding Information:
The authors received no financial support for the research and/or authorship of this article. We thank the Wiley Editing Services team for the English revision of the manuscript.
Publisher Copyright:
© 2019 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals, Inc.
PY - 2019/11
Y1 - 2019/11
N2 - 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: τ = −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: τ = −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: τ = −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: 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.
AB - 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: τ = −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: τ = −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: τ = −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: 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.
KW - coronary artery bypass grafting
KW - coronary artery disease
KW - proximal anastomoses
KW - ARTERY-BYPASS SURGERY
KW - AORTIC MANIPULATION
KW - NEUROLOGICAL COMPLICATIONS
KW - PROXIMAL ANASTOMOSIS
KW - PATENCY RATE
KW - FOLLOW-UP
KW - CORONARY
KW - GRAFT
KW - SYSTEM
KW - IMPACT
U2 - 10.1111/jocs.14186
DO - 10.1111/jocs.14186
M3 - (Systematic) Review article
C2 - 31472023
SN - 0886-0440
VL - 34
SP - 1297
EP - 1304
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
IS - 11
ER -