The Effects of Aortic Clamping Strategy on Myocardial Protection and Early Postoperative Outcomes During Coronary Artery Bypass Grafting Operations

Aortic Clamping Strategy on Coronary Surgery

Authors

  • Cüneyt Eris, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Mimar Sinan Town. Yıldırım/BURSA, Turkey
  • Burak Erdolu, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Mimar Sinan Town. Yıldırım/BURSA, Turkey
  • Mesut Engin, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Mimar Sinan Town. Yıldırım/BURSA, Turkey
  • Ahmet Kagan As, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Mimar Sinan Town. Yıldırım/BURSA, Turkey
  • Yasemin Ustundag, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Clinical Biochemistry, Mimar Sinan Town. Yıldırım/BURSA, Turkey

DOI:

https://doi.org/10.1532/hsf.3475

Keywords:

Myocardial Protection, Ischemia-Reperfusion, Coronary Bypass, Biomarkers

Abstract

Background: The purpose of the present study was to compare the effects of two different clamping strategies for the construction of the proximal aortocoronary anastomoses on myocardial protection and postoperative outcomes during coronary artery bypass grafting (CABG) operations.

Methods: In this retrospective study, we examined prospectively collected data of patients who underwent CABG for a 3-year period. Two hundred consecutive patients, who were diagnosed with triple vessel coronary artery disease (CAD), were selected and divided into two groups. In Group 1 (single clamp) (N = 100), venoaortic proximal anastomoses were performed using a single aortic cross-clamp, while in Group 2 (double clamp) (N = 100), proximal anastomoses were performed by using an aortic side clamp. Operative and postoperative outcomes of the patients were compared between the two groups. The serum levels of myocardial damage biomarkers, creatine phosphokinase-MB (CPK-MB), and high sensitive Troponin (hsTnI) results were measured preoperatively, intraoperatively, and postoperatively (6, 12, 24, and 48 hours).

Results: Patient demographics and characteristics were similar between the two groups. In Group 1, cross-clamp duration time (65 min versus 49 min; P = .0001) was longer. However, perfusion time (91 min versus 85 min; P = .61) was similar between the two groups. In Group 2, postoperative CK-MB levels were significantly higher intraoperatively
(P = .18), 6 hours (P = .22), 24 hours (P = .001), and 48 hours (P = .001) than in Group 1. HsTnI was only significantly higher in Group 2 versus Group 1 at 24 hours (P = .001) and 48 hours (P = .01) postoperatively. Time of intensive care unit stay, duration of extubation, and length of hospital stay were similar in both groups.

Conclusion: The technique used for proximal anastomosis has a significant effect on perioperative results, especially on myocardial protection.

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Published

2021-03-03

How to Cite

Eris, C., Erdolu, B., Engin, M., Kagan As, A., & Ustundag, Y. (2021). The Effects of Aortic Clamping Strategy on Myocardial Protection and Early Postoperative Outcomes During Coronary Artery Bypass Grafting Operations: Aortic Clamping Strategy on Coronary Surgery. The Heart Surgery Forum, 24(2), E217-E222. https://doi.org/10.1532/hsf.3475

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