Off-pump coronary bypass grafting with or without the use of intracoronary shunts

  • Ehab Salah Eldin Elsharkawe Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
  • Hend Mahmoud Nasser Department of Anesthesiology, Intensive care, Menofia University, Menofia, Egypt
  • Hosam Fathy Ali Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
Keywords: coronary artery bypass grafting, off-pump surgery, intracoronary shunt, coronary clamping

Abstract

Background: There is scarce literature comparing the role of the intracoronary shunt during off-pump coronary artery bypass grafting (CABG). This study aimed to compare off-pump CABG using intracoronary shunt versus the coronary clamp during distal coronary artery anastomosis.

Methods: We conducted this randomized study between January and June 2018. We randomized 30 patients into two groups. Group A (n= 15) included patients who had coronary clamping during off-pump CABG, and Group B (n= 15) included patients who had intracoronary shunt during off-pump CABG. Study endpoints were anastomosis time and postoperative cardiac enzyme levels.

Results: The mean age of the shunt group was higher than the mean age of the clamp group (61.06 ± 7.26 vs. 56.72 ± 12.44, respectively, p=0.03). Our study showed no statistical difference between the two groups regarding sex (p˃0.99), hypertension (p˃0.99), and diabetes (p=0.14). The distal anastomosis time was longer in the shunt group than in the clamp group (39.80±4.55 vs. 32.27±6.06 minutes, respectively, p=0.001). The postoperative troponin I (0.61±0.11 vs. 0.26±0.089 ƞg/ml, p<0.001), and CK-MB levels (44.27±5.34 vs. 35.5±4.86 IU/L, p<0.001) were significantly higher in the clamp group.

Conclusion: The intracoronary shunt could be associated with lower cardiac enzyme release compared to the clamp technique. However, it was associated with a longer distal anastomosis time.

Published
2020-10-01
How to Cite
Salah Eldin Elsharkawe, E., Mahmoud Nasser, H., & Fathy Ali, H. (2020). Off-pump coronary bypass grafting with or without the use of intracoronary shunts. The Egyptian Cardiothoracic Surgeon, 2(4), 155 - 161. Retrieved from https://journals.escts.net/ects/article/view/147
Section
Adult cardiac