1. Introducing sequential partial aortic clamp technique for proximal anastomoses and its advantages in myocardial protection in coronary artery bypass grafting.
- Author
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Khajeh R, Zarrabi K, Ouhadian M, Bazrafshan Drissi H, Bazrafshan M, Bonyadi MM, Saeedizadeh H, Aliakbarpour M, Ghazinour M, Shafa M, and Rahmanian M
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Constriction, Myocardial Ischemia surgery, Case-Control Studies, Atrial Fibrillation surgery, Postoperative Complications prevention & control, Coronary Artery Bypass methods, Coronary Artery Bypass adverse effects, Anastomosis, Surgical methods, Aorta surgery
- Abstract
Ischemic heart disease (IHD) is a common and potentially lethal cardiovascular disorder. Coronary artery bypass grafting (CABG) is a standard procedure for treating IHD. This study aims to introduce a novel technique for proximal anastomoses in CABG. This clinical trial studied 29 cases and 29 matched controls. Data were gathered from June 2014 to June 2023. Regarding proximal anastomoses, the sequential partial aortic clamp was performed in cases, and the partial aortic clamp was done for controls. In the sequential partial aortic clamp technique, a relatively small or medium vascular clamp was used instead of one clamp for all proximal anastomoses, which closed a small amount of the aortic wall at each stage. At each stage, only one hole in the aortic wall and only one anastomosis between the conduit and the aorta was performed. After the end of each anastomosis, the clamp was opened and placed on another part of the aorta, and the next anastomosis was performed. CK-MB (p < 0.001, Eta Squared = 0.255) level was significantly lower in cases that underwent sequential partial ascending aorta clamping. However, cTnI level was not statistically different among cases and controls(p = 0.05). Of all patients, 3 (10.3%) cases and 12 (41.4%) controls developed with postoperative atrial fibrillation (p = 0.007). The sequential partial aortic clamp technique leads to less myocardial injury than the partial aortic clamp technique. Also, patients undergoing sequential partial aortic clamp technique are less likely to develop postoperative atrial fibrillation., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Shiraz University of Medical Sciences (IR.SUMS.REC.1393.6509), and written informed consent was obtained from the subjects. Each patient was assigned a code at the beginning of the study, and patients’ data were gathered and analyzed anonymously. All methods were carried out in accordance with relevant guidelines and regulations., (© 2024. The Author(s).) more...
- Published
- 2024
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