[Evaluation of off-pump coronary artery bypass grafting based on systemic inflammatory response syndrome]

Assessment of the less-invasiveness of off-pump coronary artery bypass grafting (OP-CAB) was made by the view point of systemic inflammatory response syndrome (SIRS). Single vessel OP-CAB with median sternotomy (MS(+)OP-CAB group, n = 13), single vessel OP-CAB without median sternotomy (MS(-)OP-CAB group, n = 9), two vessels conventional coronary artery bypass grafting (C-CAB) by normothermic extra corporeal circulation with steroid (methylprednisolone) (s(+)C-CAB group, n = 13), and two vessels C-CAB without steroid (s(-)C-CAB group, n = 13) were compared with each other. The criteria for SIRS was two or more of the following conditions: (1) temperature > 38.0 degrees C, (2) respiratory rate > 20 breaths/min, (3) heart rate > 90 beats/min, (4) white blood cells > 12,000 cells/mm3. Patients' date such as age, sex, risk factors, ejection fraction, operation time, aortic or LAD clamping time, frequency of SIRS, duration of SIRS, total application number of SIRS, mean application number of SIRS, hospitalization period, rate of renal or liver dysfunction were compared, and the following results were obtained. 1) MS(+)OP-CAB group had less-invasiveness than s(-)C-CAB group. The invasiveness of extra corporeal circulation was clear. 2) s(+)C-CAB group had equal invasiveness to MS(+)OP-CAB group. The anti-SIRS effect and organ protect effect of steroid was suggested. 3) MS(-)OP-CAB group had equal invasiveness to MS(+)OP-CAB group. The invasiveness of median full sternotomy was not so strong.