Methods: Between November 1st, 2014 and December 31st, 2022, a total of 1,154 off-pump coronary artery bypass grafting patients (963 males, 191 females; mean age: 64±10.9 years; range, 13 to 95 years) were retrospectively analyzed. Demographic characteristics, preexisting comorbidities, perioperative status, and postoperative clinical outcomes of the patients were recorded. Survival analysis was carried out.

Results: No-touch aorta coronary artery bypass grafting was performed 958 (83%) patients and single side-biting clamp was used in 196 (17%) patients. Two-hundred seventy-one (23.5%) patients were in an emergent condition, and 63 (5.5%) patients had a history of stroke and/or transient ischemic attack preoperatively. Concomitant carotid endarterectomy was performed in 50 (4.3%) patients. Postoperatively, 139 (12%) patients had atrial fibrillation and five (0.4%) patients had stroke. Seven patients (0.6%) died in the hospital and one (0.08%) patient died in the postoperative 30-day period. One-year, three-year, and five-year survival rates were 98.7%, 97.4%, and 96.5%, respectively.

Conclusion: Off-pump coronary artery bypass grafting is associated with a low incidence of perioperative stroke. Avoidance of aortic manipulation in off-pump coronary artery bypass grafting may reduce the risk of adverse neurological effects of cardiopulmonary bypass. We attribute the long-term survival to shorter lengths of stay in the intensive care unit and hospital and less need for blood products after surgery.