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Which is first: Left anterior descending artery anastomosis or right coronary artery anastomosis in off-pump coronary artery bypass grafting?

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dc.contributor.author Yakut, N.
dc.contributor.author Tulukoǧlu, E.
dc.contributor.author Emrecan, B.
dc.contributor.author Bayrak, S.
dc.contributor.author Yilik, L.
dc.contributor.author Göktoǧan, T.
dc.contributor.author Gürbüz, A.
dc.date.accessioned 2019-08-16T12:09:33Z
dc.date.available 2019-08-16T12:09:33Z
dc.date.issued 2009
dc.identifier.issn 10983511 (ISSN)
dc.identifier.uri http://acikerisim.pau.edu.tr:8080/xmlui/handle/11499/6675
dc.description.abstract Objectives: The sequence of the distal anastomosis for revascularization in off-pump coronary artery bypass grafting (OPCABG) surgery is under debate. The hypothesis in this study was that an analysis of cardiac markers would reveal that anastomosing the left anterior descending coronary artery (LAD) before the right coronary artery (RCA) would decrease myocardial damage in OPCABG surgery for 2-vessel disease. Methods: Forty patients with stable angina who underwent OPCABG surgery and who had LAD and RCA lesions were randomized into 2 groups of 20 patients each. The LAD was revascularized first in group 1, and the RCA was revascularized first in group 2. Cardiac troponin I, creatine kinase (CK), and CK myocardial band (CK-MB) were measured in the 2 groups before surgery and at 8, 24, and 48 hours after surgery. Results: No mortality occurred in the 2 groups. The groups were similar with respect to sex, age, durations of anastomosis of the left internal thoracic artery to the LAD and of the saphenous vein graft to the RCA, and preoperative CK, CK-MB, and troponin I levels. Postoperative CK-MB levels were significantly higher in group 2 in the eighth and 24th postoperative hours than in group 1 (P = .009 and .041, respectively). Similarly, troponin I levels were significantly higher in group 2 in the eighth, 24th, and 48th hours than in group 1 (P = .003, .003, and .006, respectively). Conclusions: Anastomosis to the LAD first in OPCABG surgery led to a slight reduction in myocardial enzyme release against the occlusion of the target vessels during anastomoses in patients with RCA and LAD stenoses.
dc.language.iso English
dc.relation.isversionof 10.1532/HSF98.20091075
dc.subject creatine kinase
dc.subject creatine kinase MB
dc.subject troponin I
dc.subject adult
dc.subject artery anastomosis
dc.subject article
dc.subject clinical article
dc.subject clinical trial
dc.subject controlled clinical trial
dc.subject controlled study
dc.subject coronary artery obstruction
dc.subject enzyme release
dc.subject female
dc.subject heart muscle injury
dc.subject human
dc.subject hypothesis
dc.subject internal mammary artery
dc.subject left anterior descending coronary artery
dc.subject male
dc.subject off pump coronary surgery
dc.subject postoperative period
dc.subject preoperative period
dc.subject priority journal
dc.subject prospective study
dc.subject randomized controlled trial
dc.subject revascularization
dc.subject right coronary artery
dc.subject saphenous vein graft
dc.subject stable angina pectoris
dc.subject vascular disease
dc.subject aged
dc.subject anastomosis
dc.subject angina pectoris
dc.subject blood
dc.subject comparative study
dc.subject coronary blood vessel
dc.subject enzymology
dc.subject heart infarction
dc.subject heart muscle revascularization
dc.subject methodology
dc.subject middle aged
dc.subject postoperative complication
dc.subject transplantation
dc.subject vein
dc.subject Aged
dc.subject Anastomosis, Surgical
dc.subject Angina Pectoris
dc.subject Coronary Artery Bypass, Off-Pump
dc.subject Coronary Vessels
dc.subject Creatine Kinase
dc.subject Creatine Kinase, MB Form
dc.subject Female
dc.subject Humans
dc.subject Internal Mammary-Coronary Artery Anastomosis
dc.subject Male
dc.subject Middle Aged
dc.subject Myocardial Infarction
dc.subject Postoperative Complications
dc.subject Prospective Studies
dc.subject Troponin I
dc.subject Veins
dc.title Which is first: Left anterior descending artery anastomosis or right coronary artery anastomosis in off-pump coronary artery bypass grafting?
dc.type Article
dc.relation.journal Heart Surgery Forum
dc.identifier.volume 12
dc.identifier.issue 5
dc.identifier.startpage E256
dc.identifier.endpage E260
dc.identifier.index Scopus


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