Serum cardiac troponin I after conventional and minimal invasive coronary artery bypass surgery.
We evaluated myocardial release of cardiac troponin I (cTnI) in patients treated with conventional coronary artery bypass grafting (CABG), which employs extracorporeal circulation, and different kinds of minimal invasive coronary artery bypass grafting (MICABG), a surgical technique where the operation is performed without extra-corporeal circulation. Furthermore, we evaluated the usefulness of serum cTnI measurement to detect perioperative myocardial infarction (PMI) after coronary artery bypass surgery. Thirty-one patients were included: sixteen underwent CABG, fifteen underwent different MICABG and five patients had PMI. Blood specimens for cTnI measurements were collected up to 72 hours after opening the graft. Aortic cross-clamping time was a minor determinant of myocardial damage; on the other side, the trauma during surgery correlated with the number of involved arteries and with the manoeuvre employed to obtain heart dislocation, and appeared a more important determinant of myocardial damage. In patients with PMI, the cumulative release of cTnI was higher than in patients free from PMI; however, only after 24-72 hours we observed significant differences in serum cTnI values, because the increased perioperative values of cTnI complicated the interpretation of the myocardial status and a single cut-off could not be used to exclude PMI.
Cattozzo
G
G
Laboratorio di Analisi, Ospedale Del Ponte-A. O. Fondazione Macchi, Varese, Italy. giampaolo.cattozzo@tin.it
Finazzi
S
S
Ferrarese
S
S
Sala
A
A
Melzi d'Eril
G V
GV
D001026:Coronary Artery Bypass; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009203:Myocardial Infarction / Q000097:blood* / Q000601:surgery*; D015203:Reproducibility of Results; D019210:Troponin I / Q000097:blood*
D019210:Troponin I