Intracoronary shunt reduces postoperative troponin leaks: a prospective randomized study.
OBJECTIVE
The purpose of this study was to evaluate whether intracoronary shunt usage reduced the myocardial damage on the basis of the cardiac markers when compared with the shuntless anastomosis in off-pump coronary artery bypass grafting (OPCABG) surgery of isolated left anterior descending artery lesions.


METHODS
Forty patients who had stable angina with isolated left anterior descending (LAD) coronary artery lesion undergoing OPCABG surgery were randomized into two groups. Shunt group consisted of 20 patients who had OPCABG using intracoronary shunt, whereas the shuntless group consisted of 20 patients who underwent OPCABG without using intracoronary shunt. Cardiac troponin I, CK, and CK-MB before and 24h after the surgery were assessed in the groups.


RESULTS
There were no deaths in the study. The two groups were similar with respect to sex and age. Duration of LIMA-LAD anastomosis was significantly higher in the shunt group (p=0.01). There was no significant difference between the groups concerning the preoperative and postoperative CK and CK-MB levels. The preoperative troponin I levels of the groups were not different (p=0.238; NS), whereas postoperative levels of this marker was significantly higher in the shuntless group (p=0.003).


CONCLUSIONS
Intracoronary shunt reduced the postoperative troponin I levels significantly, so it may be indicated in the patients who are thought to be susceptible to transient ischemia.
Gürbüz
Ali
A
Department of Cardiovascular Surgery, Izmir Ataturk Training and Research Hospital, Izmir, Turkey.
Emrecan
Bilgin
B
Yilik
Levent
L
Ozsöyler
Ibrahim
I
Kestelli
Mert
M
Ozbek
Cengiz
C
Karahan
Nagihan
N
D000368:Aged; D000714:Anastomosis, Surgical; D000789:Angina, Unstable / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000032:analysis; D016009:Chi-Square Distribution; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D003402:Creatine Kinase / Q000032:analysis; D052279:Creatine Kinase, MB Form / Q000032:analysis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000517:prevention & control; D009206:Myocardium / Q000737:chemistry; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D019210:Troponin I / Q000032:analysis*
D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form