A survey of current myocardial protection practices during coronary artery bypass grafting

Area of Science:

• Cardiovascular Surgery
• Surgical Techniques
• Myocardial Protection

Background:

• Coronary artery bypass grafting (CABG) is a common cardiac surgical procedure.
• Effective myocardial protection is crucial for optimizing outcomes during CABG.
• Current practices in myocardial protection strategies may vary geographically and evolve over time.

Purpose of the Study:

• To investigate and document the contemporary myocardial protection strategies employed in CABG procedures across the United Kingdom and Ireland.
• To identify trends and variations in the application of different myocardial protection techniques.

Main Methods:

• A questionnaire survey was distributed to cardiac surgeons in the UK and Ireland between June and October 2002.
• The survey list was compiled from the Society of Cardiothoracic Surgeons of Great Britain and Ireland database.
• Responses were collected via postal and electronic mail.

Main Results:

• A response rate of 73.7% (118 surgeons) was achieved.
• On-pump CABG (ONCAB) was performed by 51.7% of respondents, off-pump CABG (OPCAB) by 8.5%, and 39.8% used either method.
• Cardioplegia (84.3%) was the predominant method for ONCAB, with blood cardioplegia (78.9% cold, 19.7% warm) being most common. Significant variations were noted in specific techniques like hypothermia and venting.
• For OPCAB, the Octopus stabilizer (77.2%) was favored, with intracoronary shunts (70.3%) being commonly used.

Conclusions:

• The survey provides valuable insight into the diverse range of myocardial protection strategies currently utilized in CABG within the UK and Ireland.
• Observed variations in practice highlight the evolving nature of myocardial protection and may inform future clinical guidelines and research.
• The findings serve as a useful reference for understanding current surgical practices in the region.