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Published on: October 14, 2016
Influence of intracoronary shunt on myocardial damage: a prospective randomized study
Mustafa Emmiler1, Cevdet Ugur Kocogullari, Yuksel Ela
1Department of Cardiovascular Surgery, Faculty of Medicine Kocatepe University, Afyonkarahisar, Turkey. dremmiler@yahoo.com
Insights
Surgical intracoronary shunt use in patients with moderate left ventricular dysfunction (MLVD) significantly reduced cardiac enzyme levels and improved ejection fraction (EF), demonstrating myocardial protection.
Area of Science:
- Cardiology
- Cardiac Surgery
- Cardiovascular Research
Background:
- Moderate left ventricular dysfunction (MLVD) poses challenges in cardiac surgery.
- Myocardial protection strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the protective effects of surgical intracoronary shunt on myocardium in patients with MLVD.
- To compare cardiac enzyme levels, atrial fibrillation rates, and ejection fraction (EF) between shunt and shuntless groups.
Main Methods:
- A cohort study comparing 39 patients in the shunt group with 43 in the shuntless group.
- Measurement of cardiac enzymes (Troponin I, CK, CK-MB) preoperatively and at 6, 24 hours postoperatively.
- Assessment of postoperative atrial fibrillation (AF) and third-month ejection fraction (EF).
Main Results:
- The shunt group showed significantly lower postoperative Troponin I and CK-MB levels (p<0.001).
- Third-month ejection fraction (EF) significantly increased in both groups, with a greater increase in the shunt group.
- No deaths occurred in the shunt group, compared to one death in the shuntless group.
Conclusions:
- Surgical intracoronary shunt demonstrates protective effects on the myocardium in patients with MLVD.
- The use of an intracoronary shunt is associated with improved cardiac function and reduced myocardial injury.
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 24h 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 24h). 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.
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