Article Summary

Intraluminal Shunting During Off Pump Coronary Artery Bypass Surgery

by The DiagnosisHeart.com Physician Team
Posted: February 21, 2003

Summary:
It is believed that temporary intraluminal shunting during beating heart coronary artery bypass grafting reduces the risk of developing regional myocardial ischemia during bypass grafting.

Researchers from Sao Paolo, Brazil researched this in an animal experimental model. The study was published in the most recent edition of the Heart Surgery Forum. Two groups of animals were studied. One group was shunted while the bypass grafts were constructed. In another group, the bypassed vessels were occluded during construction of the anastomosis. Shunting is the placement of a hollow tube within the bypassed vessel to allow blood flow downstream while the surgeon creates the bypass graft.

Infarct analysis was made by using biochemical end points (serum lactate dehydrogenase [LDH] and creatine phosphokinase-myocardial band [CPK-MB]) was performed with standard serologic assays. These are biochemical markers for myocardial injury.

In these experimental studies, the authors demonstrated a positive effect of shunting, which parallels the clinical experience of surgeons who have a large practice in "off-pump" coronary artery bypass grafting.

The authors concluded that "intraluminal shunts do protect the vulnerable myocardium from regional ischemia during the period of temporary coronary occlusion necessary for construction of a bypass graft on the beating heart. Temporary intraluminal shunting is a cost effective adjunct that can increase safety and reliability in "off pump" coronary artery bypass grafting.

Reference:
Experimental Evidence of Regional Myocardial Ischemia During Beating Heart Coronary Bypass: Prevention with Temporary Intraluminal Shunts, Heart Surgery Forum

Date of Article Publication:
2003, February

Web Site: http://www.hsforum.com/vol6/issue1/2002-74010.html