title: Markers of myocardial ischemia after minimally invasive and conventional coronary operation.
abstract: BACKGROUND
  The purpose of this study was to evaluate the course of serum markers of myocardial tissue damage after two different types of minimally invasive coronary surgical procedures (MICS) as compared with conventional coronary artery bypass grafting (CABG).
  
  
  METHODS
  We enrolled 87 patients with one- or two-vessel disease scheduled for one of the three procedures: minimally invasive direct coronary artery bypass grafting (MIDCABG) by lateral thoracotomy (n = 29), the OCTOPUS method by median sternotomy (n = 27), and CABG (n = 31). Creatine kinase activity (CK), creatine kinase MB activity (CK-MB act), creatine kinase MB mass concentration (CK-MB mass), myoglobin concentration (MG), and cardiac troponin I concentration (cTnI) were measured perioperatively until the second postoperative day.
  
  
  RESULTS
  Creatine kinase-MB, CK-MB mass, and cTnI were significantly higher after CABG and were nearly maintained within the normal range in MICS. Creatine kinase and MG were significantly lower in the OCTOPUS group than in the MIDCABG or CABG groups.
  
  
  CONCLUSIONS
  Minimally invasive coronary surgical procedures cause less myocardial injury than CABG as indicated by specific serum markers. However, higher CK and MG reflect more substantial skeletal muscle trauma during MIDCABG operation compared with OCTOPUS procedures.
authors.affiliation: Department of Anesthesiology, Ludwig-Maximilian-University of Munich, Germany. erichkilger@ana.med.uni-muenchen.de
authors.forename: E
authors.initials: E
authors.lastname: Kilger
authors.forename: B
authors.initials: B
authors.lastname: Pichler
authors.forename: F
authors.initials: F
authors.lastname: Weis
authors.forename: A
authors.initials: A
authors.lastname: Goetz
authors.forename: P
authors.initials: P
authors.lastname: Lamm
authors.forename: A
authors.initials: A
authors.lastname: Schütz
authors.forename: D
authors.initials: D
authors.lastname: Muehlbayer
authors.forename: L
authors.initials: L
authors.lastname: Frey
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis*; D009211:Myoglobin / Q000097:blood; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
chemical_list: D007527:Isoenzymes; D009211:Myoglobin; D019210:Troponin I; D003402:Creatine Kinase