Overview
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.
Eligibility
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.
