Release of S100B during coronary artery bypass grafting is reduced by off-pump surgery.
BACKGROUND
S100B, a plasma marker of brain injury, was compared after coronary artery bypass grafting with and without cardiopulmonary bypass (CPB).


METHODS
Fourteen patients with off-pump operations and 18 patients with CPB were compared. Seven patients in the off-pump group underwent a minithoracotomy and received only an arterial graft, whereas 7 patients underwent sternotomy and received both an arterial and one or two vein grafts. S100B was measured in arterial plasma using an immunoassay with enhanced sensitivity.


RESULTS
S100B before the operation was 0.03 microg/L. At wound closure, S100B in patients of the off-pump and CPB groups reached a maximum level of 0.22 +/- 0.07 and 2.4 +/- 1.5 microg/L, respectively (p < 0.001). No strokes occurred. Patients without CPB receiving arterial and vein grafts released slightly more S100B (p < 0.05) than patients with only arterial grafting. In patients undergoing CPB, S100B increased slightly before aortic cannulation (p < 0.001), to the same level as the maximum reached for the non-CPB group.


CONCLUSIONS
Coronary artery bypass grafting with CPB caused a 10-fold greater increase in S100B than off-pump grafting. S100B release after off-pump sternotomy with vein grafting was slightly greater than in arterial grafting through a minithoracotomy.
Anderson
R E
RE
Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden. russell.anderson@kirurgi.ki.se
Hansson
L O
LO
Vaage
J
J
D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000097:blood / Q000601:surgery*; D006801:Humans; D007118:Immunoassay; D008875:Middle Aged; D011446:Prospective Studies; D009418:S100 Proteins / Q000097:blood*; D013249:Sternum / Q000601:surgery; D013908:Thoracotomy / Q000379:methods
D009418:S100 Proteins