{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:38:54Z","timestamp":1791333534468,"version":"4.3.1"},"reference-count":46,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2007,2,1]],"date-time":"2007-02-01T00:00:00Z","timestamp":1170288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2016,7,6]],"date-time":"2016-07-06T00:00:00Z","timestamp":1467763200000},"content-version":"vor","delay-in-days":3443,"URL":"https:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Thoracic and Cardiovascular Surgery"],"published-print":{"date-parts":[[2007,2]]},"DOI":"10.1016\/j.jtcvs.2006.10.002","type":"journal-article","created":{"date-parts":[[2007,1,26]],"date-time":"2007-01-26T17:43:38Z","timestamp":1169833418000},"page":"485-493","source":"Crossref","is-referenced-by-count":81,"title":["Gaseous and solid cerebral microembolization during proximal aortic anastomoses in off-pump coronary surgery: The effect of an aortic side-biting clamp and two clampless devices"],"prefix":"10.25013","volume":"133","author":[{"given":"Lorenzo Guerrieri","family":"Wolf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasir","family":"Abu-Omar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikram P.","family":"Choudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pigott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Taggart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jtcvs.2006.10.002_bib1","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/00001573-200109000-00003","article-title":"Neurological and cognitive disorder after CABG","volume":"16","author":"Taggart","year":"2001","journal-title":"Curr Opin Cardiol"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib2","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1056\/NEJM199612193352501","article-title":"Adverse cerebral outcomes after coronary bypass surgery","volume":"335","author":"Roach","year":"1996","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib3","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1067\/mtc.2000.108901","article-title":"Neurocognitive dysfunction after coronary artery bypass surgery: a systematic review","volume":"120","author":"van Dijk","year":"2000","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib4","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1056\/NEJM200102083440601","article-title":"Longitudinal assessment of neurocognitive function after coronary artery bypass surgery","volume":"344","author":"Newman","year":"2001","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib5","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1016\/S0022-5223(19)34874-3","article-title":"Atheroembolism from the ascending aorta: an emerging problem in cardiac surgery","volume":"103","author":"Blauth","year":"1992","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib6","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S0022-5223(19)34806-8","article-title":"Clamping of the atherosclerotic ascending aorta during coronary artery bypass operations: its cost in stroke","volume":"104","author":"Bar-El","year":"1992","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib7","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/S0140-6736(02)09557-0","article-title":"Off-pump coronary artery bypass grafting","volume":"360","author":"Abu-Omar","year":"2002","journal-title":"Lancet"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib8","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1016\/S0022-5223(19)33878-4","article-title":"Risk factors for stroke after coronary artery bypass","volume":"104","author":"Lynn","year":"1992","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib9","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1161\/01.STR.25.12.2398","article-title":"Cerebral emboli detected during bypass surgery are associated with clamp removal","volume":"25","author":"Barbut","year":"1994","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib10","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0022-5223(19)34984-0","article-title":"Management of the severely atherosclerotic ascending aorta during cardiac operations","volume":"103","author":"Wareing","year":"1992","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib11","first-page":"509","article-title":"Neuropsychological deficits are associated with the number of emboli detected during cardiac surgery","volume":"24","author":"Stump","year":"1993","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib12","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1161\/01.STR.25.7.1393","article-title":"The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning","volume":"25","author":"Pugsley","year":"1994","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib13","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/S1053-0770(96)80186-8","article-title":"Cerebral emboli and cognitive outcome after cardiac surgery","volume":"10","author":"Stump","year":"1996","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib14","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1016\/S0003-4975(98)00891-1","article-title":"Pattern and significance of cerebral microemboli during coronary artery bypass grafting","volume":"66","author":"Sylivris","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib15","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.ejcts.2004.05.022","article-title":"The role of microembolisation in cerebral injury as defined by functional magnetic resonance imaging","volume":"26","author":"Abu-Omar","year":"2004","journal-title":"Eur J Cardiothorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib16","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1016\/j.jtcvs.2003.09.048","article-title":"Solid and gaseous microembolization during off-pump, on-pump, and open cardiac surgery procedures","volume":"127","author":"Abu-Omar","year":"2004","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib17","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jtcvs.2004.06.013","article-title":"No-touch aorta off-pump coronary surgery: the effect on stroke","volume":"129","author":"Lev-Ran","year":"2005","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib18","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1016\/j.athoracsur.2004.05.019","article-title":"The impact of aortic manipulation on neurologic outcomes after coronary artery bypass surgery: a risk-adjusted study","volume":"78","author":"Kapetanakis","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib19","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0022-5223(03)00395-7","article-title":"Modification of surgical technique for ascending aortic atherosclerosis: impact on stroke reduction in coronary artery bypass grafting","volume":"126","author":"Hangler","year":"2003","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib20","first-page":"28","article-title":"Does off-pump total arterial revascularization without aortic manipulation influence neurological outcome? A study of 226 consecutive, unselected cases","volume":"5","author":"Patel","year":"2002","journal-title":"Heart Surg Forum"},{"issue":"Suppl","key":"10.1016\/j.jtcvs.2006.10.002_bib21","doi-asserted-by":"crossref","first-page":"S1377","DOI":"10.1016\/S0003-4975(02)04060-2","article-title":"Off-pump coronary artery bypass with complete avoidance of aortic manipulation","volume":"74","author":"Kim","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib22","first-page":"169","article-title":"Improving neurologic outcome in off-pump surgery: the \u201cno touch\u201d technique","volume":"6","author":"Leacche","year":"2003","journal-title":"Heart Surg Forum"},{"issue":"Suppl 4","key":"10.1016\/j.jtcvs.2006.10.002_bib23","first-page":"S272","article-title":"Extraanatomical coronary artery bypass grafts on the beating heart for management of the severely atherosclerotic ascending aorta","volume":"5","author":"Bonatti","year":"2002","journal-title":"Heart Surg Forum"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib24","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1067\/mtc.2001.112829","article-title":"Early clinical experience with a new sutureless anastomotic device for proximal anastomosis of the saphenous vein to the aorta","volume":"121","author":"Calafiore","year":"2001","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib25","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1016\/S0003-4975(02)04039-0","article-title":"Assessment of an aortosaphenous vein graft anastomotic device in coronary surgery: clinical experience and early angiographic results","volume":"74","author":"Antona","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib26","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jtcvs.2003.11.045","article-title":"Initial experience with the Heartstring proximal anastomotic system","volume":"128","author":"Medalion","year":"2004","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib27","doi-asserted-by":"crossref","first-page":"E4","DOI":"10.1532\/hsf.715","article-title":"Guidant Heartstring: initial experience in OPCAB surgery","volume":"8","author":"Weber","year":"2005","journal-title":"Heart Surg Forum"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib28","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/j.athoracsur.2004.05.080","article-title":"First clinical experience with the HEARTSTRING, a device for proximal anastomoses in coronary surgery","volume":"79","author":"Vicol","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib29","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.ejcts.2004.02.036","article-title":"Automatic connector devices for proximal anastomoses do not decrease embolic debris compared with conventional anastomoses in CABG","volume":"25","author":"Martens","year":"2004","journal-title":"Eur J Cardiothorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib30","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S0003-4975(03)01587-X","article-title":"Initial experience with sutureless proximal anastomoses performed with a mechanical connector leading to clampless off-pump coronary artery bypass surgery","volume":"77","author":"Katariya","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib31","doi-asserted-by":"crossref","first-page":"S995","DOI":"10.1016\/S0003-4975(01)02965-4","article-title":"Minimizing aortic manipulation during OPCAB using the Symmetry aortic connector system for proximal vein graft anastomoses","volume":"72","author":"Eckstein","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib32","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/S0022-5223(20)31425-2","article-title":"Atherosclerosis of the ascending aorta and coronary artery bypass: pathology, clinical correlates, and operative management","volume":"102","author":"Mills","year":"1991","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib33","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.ejcts.2005.02.041","article-title":"Clinical experience with the Novare Enclose II manual proximal anastomotic device during off-pump coronary artery surgery","volume":"27","author":"Akpinar","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib34","unstructured":"Guidant Corporation. HEARTSTRING Proximal Seal System. Instructions for use. Santa Clara (CA). 2002."},{"key":"10.1016\/j.jtcvs.2006.10.002_bib35","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1161\/01.STR.0000022811.46115.70","article-title":"Automatic online embolus detection and artifact rejection with the first multifrequency trancranial Doppler","volume":"33","author":"Brucher","year":"2002","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib36","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1161\/01.STR.0000022809.46400.4B","article-title":"Online automatic discrimination between solid and gaseous cerebral microemboli with the first multifrequency trancranial Doppler","volume":"33","author":"Russell","year":"2002","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib37","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1161\/01.STR.0000157956.44063.f2","article-title":"Embolus detection and differentiation using multifrequency transcranial Doppler","volume":"36","author":"Russell","year":"2005","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib38","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1161\/01.STR.29.9.1821","article-title":"Microemboli in cerebral circulation and alteration of cognitive abilities in patients with mechanical prosthetic heart valves","volume":"29","author":"Deklunder","year":"1998","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib39","first-page":"205","article-title":"MRI and cerebrospinal fluid enzymes as sensitive indicators of subclinical cerebral injury after open-heart valve replacement surgery","volume":"17","author":"Steinberg","year":"1996","journal-title":"Am J Neuroradiol"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib40","first-page":"111","article-title":"Microbubble damage to the blood-brain barrier: relevance to decompression sickness","volume":"18","author":"Hills","year":"1991","journal-title":"Undersea Biomed Res"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib41","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/S0022-5223(03)00800-6","article-title":"Combination of the HEARTSTRING proximal seal system with a blower mister: a possible source of gas emboli","volume":"126","author":"Nollert","year":"2003","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib42","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1016\/S0022-5223(03)01039-0","article-title":"Combined use of off-pump techniques and a sutureless proximal aortic anastomotic device reduces cerebral microemboli generation during coronary artery bypass grafting","volume":"126","author":"Scarborough","year":"2003","journal-title":"J Thorac Cardiovasc Surg"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib43","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1016\/S0003-4975(00)01238-8","article-title":"Stroke in octogenarians undergoing coronary artery surgery with and without cardiopulmonary bypass","volume":"69","author":"Ricci","year":"2000","journal-title":"Ann Thorac Surg"},{"issue":"12 Suppl 1","key":"10.1016\/j.jtcvs.2006.10.002_bib44","first-page":"I5","article-title":"Reduced mortality and strokes with off-pump coronary artery bypass grafting surgery in octogenarians","volume":"106","author":"Demaria","year":"2002","journal-title":"Circulation"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib45","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1161\/01.STR.14.5.709","article-title":"Factors contributing to stroke in patients with atherosclerotic disease of the great vessels: the role of diabetes","volume":"14","author":"Weinberger","year":"1983","journal-title":"Stroke"},{"key":"10.1016\/j.jtcvs.2006.10.002_bib46","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1161\/01.STR.0000173399.20127.b3","article-title":"Can transcranial Doppler discriminate between solid and gaseous microemboli? Assessment of a dual-frequency transducer system","volume":"36","author":"Markus","year":"2005","journal-title":"Stroke"}],"container-title":["The Journal of Thoracic and Cardiovascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S002252230601748X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S002252230601748X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T03:58:50Z","timestamp":1628395130000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S002252230601748X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,2]]},"references-count":46,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2007,2]]}},"alternative-id":["S002252230601748X"],"URL":"https:\/\/doi.org\/10.1016\/j.jtcvs.2006.10.002","relation":{},"ISSN":["0022-5223"],"issn-type":[{"value":"0022-5223","type":"print"}],"subject":[],"published":{"date-parts":[[2007,2]]}}}