Aortic No-Touch vs Partial Aortic Clamping in Off-Pump CABG

Surgical Techniques to Prevent Perioperative Neurologic Complications in Patients Undergoing Coronary Artery Bypass Grafting

To explore surgical strategies that reduce perioperative neurologic complications in cardiovascular surgery, with the aim of improving perioperative outcomes and quality of life while reducing the socioeconomic burden. Specifically:

This multicenter, randomized controlled clinical trial will evaluate the benefits of a novel aortic no-touch technique in reducing perioperative silent brain infarction(SBI) among patients undergoing surgical treatment for coronary artery disease. The findings are expected to provide a safe and effective myocardial revascularization strategy for individuals at high risk of cerebral ischemia.

Inclusion Criteria:

• Adult patients (>18 years old) with multivessel coronary artery disease who are scheduled to undergo isolated off-pump coronary artery bypass grafting and who provide informed consent to participate in this study.

Exclusion Criteria:

• Indications for cardiopulmonary bypass surgery (or no contraindications to on-pump surgery);
• Great saphenous vein is unsuitable for use as a graft conduit;
• Subclavian artery stenosis or occlusion, or any contraindication to the use of the internal mammary artery as a graft conduit;
• History of previous cardiac surgery;
• Emergency surgery;
• Inability to apply an aortic clamp due to severe ascending aortic calcification;
• Expected inability to tolerate MRI or contraindications to MRI (e.g., known intolerance to MRI, an implanted permanent pacemaker, or an anticipated need for permanent pacemaker implantation);
• Inability to complete neurocognitive assessment due to language barriers or visual/hearing impairment.