Document Detail


Risk factors for myocardial injury during off-pump coronary artery bypass grafting.
MedLine Citation:
PMID:  16239187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although off-pump coronary artery bypass grafting (CABG) is now used worldwide for coronary revascularization, the pre- and intraoperative risk factors for myocardial injury associated with the surgical procedure remain to be elucidated. We performed a multivariate analysis to investigate factors that contribute to myocardial injury during off-pump CABG. METHODS: The study population consisted of 22 patients who underwent off-pump CABG without apparent intraoperative complications. Blood samples were obtained before surgery and at 3 and 12 hours after the last anastomosis and serum Troponin T (cTnT) levels were measured to assess myocardial injury. Patient characteristics and factors related to preoperative cardiac function and the intraoperative process were analyzed to determine their correlation with serum cTnT levels, and the Spearman's correlation coefficient (r(s)) was computed. RESULTS: Neither age, preoperative cardiac function, time required for anastomosis, the number of grafts, nor the total amount of bleeding were associated with serum cTnT levels. Serum cTnT at 3 and 12 hours after completed anastomosis correlated with the product of mean systolic blood pressure and mean heart rate (double product) during anastomosis. The r(s) values at 3 and 12 hours were 0.62 (P = .002) and 0.58 (P = .004), respectively. With respect to the serum cTnT level at 12 hours, creatinine clearance (Ccr) had a slight effect on the serum cTnT values. CONCLUSIONS: High blood pressure and an increased heart rate during anastomosis are unfavorable factors for off-pump CABG. However, strict control of the blood pressure and heart rate makes it possible to subject even patients at high-risk to off-pump CABG from the viewpoints of myocardial injury.
Authors:
A Kurita; H Shintani
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  8     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2005  
Date Detail:
Created Date:  2005-10-21     Completed Date:  2006-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E401-5     Citation Subset:  IM    
Affiliation:
Center for Heart Disease, Division of Cardiovascular Surgery, Otemae Hospital, Otemae, Chuo-ku, Osaka, Japan. csurg-kurita@otemae.gr.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathies / blood,  diagnosis*,  etiology*
Coronary Artery Bypass, Off-Pump / adverse effects*
Female
Humans
Male
Risk Assessment / methods
Risk Factors
Troponin T / blood*
Chemical
Reg. No./Substance:
0/Troponin T

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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