Cognitive Dysfunction after Off-Pump Versus On-Pump Coronary Artery Bypass Surgery: A Meta-Analysis

OBJECTIVE:

A meta-analysis to compare the incidence of postoperative cognitive dysfunction (POCD) following off-pump coronary artery bypass grafting (OPCAB) versus after conventional coronary artery bypass grafting (CABG).

METHODS:

A systematic search of the Medline(®), EMBASE(®) and Cochrane Library databases was performed to identify randomized controlled trials published until the end of November 2011. Data were analysed using RevMan version 5.0 software.

RESULTS:

The literature search identified 13 randomized controlled trials which included a total of 2326 cases. Meta-analysis found that the incidence of POCD was significantly higher following CABG than after OPCAB during the perioperative period (1-2 weeks) and at 3 months postsurgery. There were no significant between-group differences at 6 or 12 months postsurgery.

CONCLUSIONS:

Compared with CABG, OPCAB was found to be associated with a reduced incidence of early-stage POCD. Caution must be taken when interpreting these findings because of limitations in the available data.