Protective role of intracoronary shunt in off-pump coronary bypass operations.
OBJECTIVE
To investigate if there are any advantages in using intracoronary shunts compared to shuntless operations, in the context of whether it has a protective role for the myocardia.


METHODS
This prospective study, included 100 patients who underwent off-pump coronary bypass surgery at 2 different cardiovascular surgery departments, namely, the Social Security Ankara Ihtisas Hospital, and Hacettepe University Hospital, Turkey, between September 2002 and July 2006. Patients were divided into 2 groups. In group 1 n=50 off-pump coronary bypass operations were performed with intracoronary shunts. In group 2 n=50 shunts were not used during off-pump. Serum creatine kinase, myoglobin, and troponin were studied.


RESULTS
There were significant increases in serum creatine kinase levels in group 2 at postoperative 6th, 12th, and 24th hours. In group 2, the increase of myoglobin was statistically significant at only the postoperative 24th hour. Troponin levels were significantly higher in group 2 at postoperative 6th, 12th, and 24th hours.


CONCLUSIONS
There are some questions regarding myocardial protection while maintaining a bloodless secure surgical field in off-pump coronary surgery. However, use of intracoronary shunts provides distal coronary flow, and reduces the risk of myocardial ischemia, while maintaining a comfortable blood free anastomosis area.
Tok
Mustafa
M
Department of Cardiovascular Surgery, Faculty of Medicine, Uludag University, Bursa, Turkey. mustafatok@uludag.edu.tr
Ucar
Halil I
HI
Dogan
Omer F
OF
Farsak
Bora
B
Yorgancioglu
Ali C
AC
D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003331:Coronary Vessels / Q000601:surgery*; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009211:Myoglobin / Q000097:blood; D011446:Prospective Studies; D014336:Troponin / Q000097:blood
D009211:Myoglobin; D014336:Troponin; D003402:Creatine Kinase