ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
THE EFFECT OF CORONARY ARTERY BYPASS GRAFTING WITH CARDIOPULMONARY BYPASS AND BEATING HEART TECHNIQUE ON CARDIAC PERFORMANCE
Ali RAHMAN, Oktay BURMA, Ayhan UYSAL, *Mustafa Kemal BAYAR, *Azize BEŞTAŞ, **Bilal ÜSTÜNDAĞ
Fırat Üniversitesi Tıp Fakültesi, Göğüs Kalp Damar Cerrahisi Ana Bilim Dalı, Elazığ,
*Fırat Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Ana Bilim Dalı, Elazığ,
** Fırat Üniversitesi Tıp Fakültesi, Biyokimya Ana Bilim Dalı, Elazığ
Background: The systemic inflammatory response syndrome induced by cardiopulmonary bypass (CPB) is responsible for organ dysfunction observed in patients undergoing coronary arterial bypass grafting (CABG). This study was conducted to determine whether patients who underwent off-pump CABG operations and thereby eliminated CPB would have improved cardiac function postoperatively.
Methods: Twenty-four patients were randomized to one of two groups: CABG with CPB (Group 1) or off-pump (Group 2). Cardiac index (CI) and left ventricular stroke work index (LVSWI) measurement were performed after anesthetic induction, after protamin, at the 0, 12, 24, and 48 hours after operation. In addition, serum myocardial bundle of creatine phosphokinase (CPK-MB), myoglobin and troponin T (TnT) were measured during the same periods.
Results: Serial CPK-MB, myoglobin, and TnT values increased significantly in both group compared with the baseline controls. But, the increase in CPK-MB and myoglobin levels in Group 1 were significantly higher than in Group 2 (p < 0.05). In Group 2, TnT levels were significantly less than those of the Group 1 (p < 0.01). Off-pump group had better CI and LVSWI than CPB group (p < 0.05). The patients in Group 1 required more inotropic drugs (p < 0.01) had increased postoperative bleeding (p < 0.05), and a longer intubation time (p < 0.01).
Conclusions: Off-pump CABG operation by using cardiac stabilization technique is safe and avoids the risk of myocardial injury.
Keywords : Cardiopulmonary bypass, beating heart, coronary bypass, cardiac index, troponin T
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