Hakan FOTBOLCU, Erhan KAYA

Reliability of multi-vessel off-pump coronary artery by-pass surgery in patients who have low risk profile

We investigated the reliability of multi-vessel off-pump coronary artery by-pass surgery in patients who have low risk profile. This study included 53 patients who undergone off-pump coronary artery by-pass surgery. Patients have been allocated two groups in terms of graft count. 1 and 2 vessel patients were defined as Group A and 3,4,5 vessel patients as Group B. Baseline and serial post-operative CK-MB values were obtained. Ejection fraction (LVEF), mitral-myocardial systolic velocities (lateral S’ and septal S’), mean E’, left ventricle filling pressure index (E/E’ ratio) and tricuspid-S’ were calculated at pre and postoperative period. Intensive care unit stay time was moderately correlated with pre mean E’ (r = -0.32, p=0.020) and pre E/E’ ratio (r = 0.34, p=0.013). ∆ CK-MB values were similar between two groups (p=0.263). There are no differences between groups in terms of ∆ LVEF, ∆ mean E’, ∆ lateral S’ and ∆ tricuspid S’. ∆ E/ E’ ratio was mildly in favour of group A patients (-2.31 ± 2.70 vs. -0.29 ± 2.89, p=0.007). Furthermore, ∆ septal S’ was slightly in favour of group A patients (0.71 ± 2.39 cm/s vs. -0.66 ± 1.73 cm/s, p=0.017). Multi-vessel off-pump coronary artery by-pass surgery seems as safe as 1 and 2 vessels despite small differences in terms of cardiac function alterations in patients who have low risk profile.

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