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Eur J Cardiothorac Surg 2008;34:1000-1004. doi:10.1016/j.ejcts.2008.08.002
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Cevdet Ugur Kocogullari
Ahmet Cekirdekci
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Right arrow Myocardial protection

Influence of intracoronary shunt on myocardial damage: a prospective randomized study

Mustafa Emmilera,*, Cevdet Ugur Kocogullaria, Yuksel Elab, Ahmet Cekirdekcia

a Department of Cardiovascular Surgery, Faculty of Medicine Kocatepe University, Afyonkarahisar, Turkey
b Department of Anesthesiology, Faculty of Medicine Kocatepe University, Afyonkarahisar, Turkey

Received 20 March 2008; received in revised form 18 July 2008; accepted 4 August 2008.

* Corresponding author. Address: ANS Arastirma ve Uygulama Hastanesi, KDC Klinigi, Afyonkarahisar, Turkey. Tel.: +90 272 2142065. (Email: dremmiler{at}yahoo.com).

Objective: We aimed to evaluate whether surgical intracoronary shunt protects myocardium in patients with moderate left ventricular dysfunction (MLVD). Methods: Thirty-nine patients consisted the shunt group and 43 patients consisted the shuntless group. Troponin I, CK, and CK-MB were measured preoperatively, and at 6 and 24 h postoperatively. Cardiac enzymes, rate of postoperative atrial fibrillation (AF) and third month ejection fraction (EF) were compared between the groups. Results: There were no significant differences between the groups for preoperative troponin I, CK, CK-MB, and postoperative CK levels (at 6 and 24 h). Postoperative troponin I and CK-MB levels were significantly lower in the shunt group (p < 0.001). Although preoperative EF of the patients were not significantly different between groups, the third month EF were significantly increased in both groups, and this increment was significantly higher in the shunt group than the shuntless group. One patient (2.3%) died in the shuntless group whereas there was no death in the shunt group. Conclusion: Intracoronary shunt has protective effects on myocardium in patients with moderate left ventricular dysfunction.

Key Words: Off-pump • Myocardial protection • Shunts






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Copyright © 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.