Neurologic complications after off-pump coronary artery bypass grafting with and without aortic manipulation: Meta-analysis of 11,398 cases from 8 studies

Avoidance of aortic manipulation during off-pump coronary artery bypass grafting decreases neurologic complications relative to standard technique in which the ascending aorta is manipulated. In patients at high risk for stroke or transient ischemic attack, we recommend avoidance of aortic manipulation during off-pump coronary artery bypass grafting.