Occluding clamp technique during coronary artery bypass grafting: single or double-clamp technique?

External manipulation of the diseased aorta during cardiac surgery is the most important mechanism leading to the detachment of atherosclerotic debris due, especially, to the use of aortic clamping. The aim of the present study was to determine the best occluding clamp technique to minimize the risk of postoperative cerebrovascular accidents in patients who undergo isolated coronary artery bypass grafting (CABG): single-clamp technique (SCT) or double-clamp technique (DCT)?

Two hundred and eighty-one consecutive patients undergoing isolated CABG in our center between January 2001 and December 2003 were enrolled. SCT was used in 145 cases and DCT was used in 136 cases. Postoperative adverse events were retrospectively compared between these two groups.

The aortic cross-clamp times were longer for patients in the SCT group, whereas the mean cardiopulmonary bypass time was shorter in the DCT group. There were no differences between the two groups in terms of postoperative stroke (0.6% SCT vs 0.7% DCT, p = NS) and hospital mortality (1.3% SCT vs 1.4% DCT, p = NS).

The results of this study suggest that, among patients who undergo CABG, there are no differences in neurologic outcome between those in whom DCT was used and those in whom SCT was employed.