Background
Although several clinical trials have compared surgical outcomes between off-pump
and on-pump coronary artery bypass grafting (CABG), whether there is a difference
in the early- and medium-term postoperative coronary microvascular functions is not
fully understood. We compared short- and medium-term coronary microvascular function
after off-pump and on-pump CABG.
Methods
A prospective study of patients undergoing off-pump and on-pump CABG. Eighty-two patients
scheduled for CABG were recruited: 38 underwent off-pump surgery and 44 on-pump surgery.
Each participant's coronary flow reserve (CFR) and diastolic function were measured
with transthoracic Doppler echocardiography six and 12 months after surgery.
Results
Baseline and hyperaemic diastolic peak flow velocity in the left anterior descending
artery were similar in both groups, as was CFR (2.22±0.66) in the off-pump group compared
with (2.13±0.61) in the on-pump group, (P = 0.54). Coronary flow reserve was significantly and inversely correlated with high
sensitivity C-reactive protein concentration (r = −0.416; P < 0.001) and positively correlated with mitral E/A-wave velocity ratio (r = 0.247; P = 0.02). Stepwise linear regression analysis revealed that only high sensitivity C-reactive
protein concentration was independently correlated with CFR (β = −0.272, P = 0.02).
Conclusions
Heart-lung bypass technique had no medium-term influence on the coronary microcirculation,
despite a possible initial unfavourable effect. Serum hs-CRP concentration was an
independent predictor of medium-term coronary microvascular dysfunction.
Keywords
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Article info
Publication history
Published online: March 19, 2016
Accepted:
February 18,
2016
Received in revised form:
February 16,
2016
Received:
December 14,
2015
Identification
Copyright
© 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
