Mahmoud Khairy
Elhaish.

Cardiothoracic Surgery Department, Assiut
University Hospital, Assiut, Egypt.

Corresponding Author: Dr.Mahmoud Khairy ElHAISH, MD.

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Cardiothoracic Surgery Department, Assiut University, Assiut, Egypt.

Telephone: (002)01224579171

E-Mail: [email protected]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Abstract

 

Objective: Evaluation of safety and
early outcome of temporal coronary clamping in comparison to intraluminal shunting,
during distal anastomosis in off-pump coronary artery bypass grafting.

Methods: To evaluate the short term outcome of coronary clamping, we randomly compared the results of 25 patients submitted to coronary clamping using microvascular clamps during off-pump CABG (group A), with the results of another 25 patients had traditional
intraluminal coronary shunting during same procedure (group B). All
patients proved to have coronary artery disease with no difference
between the groups in preoperative clinical variables.

Results: Clamp group (A) had significant
shorter operative time than shunt group (B); it was 224.2 ± 44.1
min in group (A) versus 250.4 ± 33.7   in group (B).

Our new coronary clamp was easily applied in (93%) of target
vessels but coronary shunt tube was implanted in nearly all (96%) target
vessels during distal coronary anastomosis.

No target vessels were injured on insertion or removal of coronary
clamps.

Low number
of patients in Clamp group (A) required inotropic support (adrenaline > 0.15
ug/kg/min) >
24 Hours during perioperative period. The study showed two cases of
mortality in both groups.

At 6 months
follow up; No clinical difference between both groups, but late postoperative
ejection fraction (E.F) in group (A) was better compared to group (B).

 

 

Conclusions: This temporal coronary clamping technique may be
used as an option to achieve a bloodless field during
off-pump CABG surgery. It appears to be
faster and
cheaper than intraluminal
shunting.
Also, it met current incidence of postoperative complications, mortality and intensive
care unit stay.

 

Keywords: Off-pump CABG; Coronary Clamping; Shunting.

 

 

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