title: Controversies in the use of intraluminal shunts during off-pump coronary artery bypass grafting surgery.
abstract: Technical advances have made the performance of multivessel off-pump coronary artery bypass feasible. Snaring and intraluminal shunts are the techniques used for vascular control. Snaring provides a bloodless surgical field, is usually well tolerated by the patient, and is supported by years of clinical experience. Intraluminal shunts aim to achieve hemostasis at the arteriotomy site and to allow antegrade flow to provide myocardial protection. There are unresolved issues regarding whether shunts have a clinical benefit, do provide adequate flow to provide myocardial protection, and whether they cause significant endothelial damage. In this article, we have reviewed the literature to lend perspective to these issues.
authors.affiliation: Escorts Heart Institute and Research Centre, New Delhi, India. spcollison@gmail.com
authors.forename: Sathiakar Paul
authors.initials: SP
authors.lastname: Collison
authors.forename: Anil
authors.initials: A
authors.lastname: Agarwal
authors.forename: Naresh
authors.initials: N
authors.lastname: Trehan
mesh_terms: D000818:Animals; D047549:Coronary Artery Bypass, Off-Pump / Q000295:instrumentation*; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000293:injuries; D004730:Endothelium, Vascular / Q000293:injuries; D006801:Humans; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000295:instrumentation; D014652:Vascular Diseases / Q000209:etiology; D014654:Vascular Patency