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