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Short-term results of enclose II in off-pump CABG. Comparison with the conventional aortic clamping technique.
Susumu Manabe, Kenji Sakai, Chieko Shibuya, Shogo Sakurai, Shuhei Fujita, Tatsuki Fujiwara, Taiju Watanabe, Hideto Kuroki, Tsuyoshi Hachimaru, Satoru Kawaguchi, Tomohiro Mizuno, Hirokuni Arai.
Tokyo Medical and Dental University, Tokyo, Japan.

OBJECTIVE: Stroke is a devastating complication after CABG, and its major cause is considered a cerebral embolization mostly due to aortic clamping. The clampless proximal anastomosis device enclose II is expected to minimize the aortic manipulation, but its impact on the short-term results is yet to be determined.
METHODS: Medical records of 303 patients who underwent off pump CABG were retrospectively reviewed. Enclose II were used in 217 patients and aortic clamping was performed in 86 patients.
RESULTS: There were no differences in in-hospital mortality rate (Enclose: 0.5% vs. clamp: 0%, p=1.00) and in stroke rate (Enclose: 0.5% vs. clamp: 1.2%, p=0.49). The etiologies of strokes in enclose group and in clamp group were due to postoperative cerebral emboli due to atrial fibrillation and intraoperative emboli due to aortic clamping, respectively. There was no difference in patency rate between the grafts anastomosed with Enclose II (Overall: 94.8%; SV: 94.7%, RA: 94.4%, GEA: 100%) and those with aortic clamping (Overall: 94.1%; SV: 89.0%, RA: 100%).
CONCLUSIONS: After the introduction of Enclose II, the incidence of intraoperative cerebral emboli has decreased. Enclose II is considered an effective tool which can minimize aortic manipulation without compromising the quality of the anastomosis.


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