The efficacies of modified mechanical post conditioning on myocardial protection for patients undergoing coronary artery bypass grafting
1 Department of Cardiovascular Surgery, Heart Center, Ankara University School of Medicine, Mamak Street, 06340, Dikimevi-Ankara, Turkey
2 Stem Cell Institute, Ankara University, Ankara, Turkey
3 Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
Journal of Cardiothoracic Surgery 2012, 7:73 doi:10.1186/1749-8090-7-73Published: 9 August 2012
Coronary artery bypass grafting (CABG) with cardioplegic cardiac arrest and cardiopulmonary bypass (CPB) is associated with myocardial injury. The aim of this study was to investigate whether a modified mechanical post-conditioning (MMPOC) technique has a myocardial protective effect by enhancing early metabolic recovery of the heart following revascularization.
A prospective, randomized trial was conducted at a single-center university hospital performing adult cardiac surgery. Seventy-nine adult patients undergoing first-time elective isolated multivessel coronary artery bypass grafting were prospectively randomized to MMPOC or control group. Anesthetic, cardiopulmonary bypass, myocardial protection, and surgical techniques were standardized. The post reperfusion cardiac indices, inotrope use and biochemical-electrocardiographic evidence of myocardial injury were recorded. The incidence of postoperative complications was recorded prospectively.
Operative characteristics, including CPB and aortic cross-clamp time, were similar between the two groups (p>0.05). The MMPOC group had lower troponin I and other cardiac biomarkers level post CPB and postoperatively, with greater improvement in cardiac indices (p<0.001). MMPOC shortened post surgery hospitalization from 9.1 ± 2.1 to 7.5 ± 1.6 days (p<0.001).
MMPOC technique promotes early metabolic recovery of the heart during elective CABG, leading to better myocardial protection and functional recovery.