Abstract
Background
Coronary artery bypass grafting (CABG) can be performed with or without pump. Off-pump coronary bypass surgery has become a widely used technique during recent years. Cardiac operations, with the use of CPB, have been linked to a systemic inflammatory response and also reperfusion myocardial injury. These may play a role in undesirable patient outcome.
Aim
The purpose of this study was to investigate the inflammatory changes after off-pump and on-pump coronary artery bypass surgery.
Setting
Department of Cardiovascular Thoracic surgery and Biochemistry, Lokamanya Tilak Municipal Medical College and General Hospital, Mumbai.
Materials and Methods
70 patients [40 for off pump and 30 for on pump] undergoing coronary artery bypass grafting were enrolled in this study. Arterial blood was collected through an intra-arterial catheter immediately after induction of anesthesia, as well as 1, 6, 24, 48 and 72 hours after surgery. The parameters of inflammatory response; Interleukin IL-6, Interleukin IL-8, and Complement C3a were evaluated.
Results
The groups were similar in terms of age, weight, gender ratio, and number of grafts per patient. The levels of inflammatory mediators, including interleukin (IL)-6, IL-8, and C3a, considerably increased and reached their peak levels 6 hours after termination of CPB except IL-6. IL-6 showed significantly elevation (p<0.001) over the time as compared to preoperative, with the values peaking at 24 hours. IL-6, IL-8 and C3a levels were significantly high (p<0.001) in the on-pump group in comparison with the off-pump group.
Conclusions
Off-pump coronary artery bypass surgery shows a significant reduction in inflammatory response when compared with On-pump coronary artery bypass surgery. This may contribute to improved myocardial function and faster postoperative recovery.
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Shinde, S., Kumar, P. & Neela, P. Systemic inflammatory changes after off-pump and on-pump coronary artery bypass surgery. Indian J Thorac Cardiovasc Surg 22, 10–14 (2006). https://doi.org/10.1007/s12055-006-0499-7
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DOI: https://doi.org/10.1007/s12055-006-0499-7