Off-Pump Versus On-Pump Coronary Artery Bypass Grafting Clinical Study On Myocardial Protection

Objective To compare the myocardial protection effect between off-pump coronary artery bypass (OPCAB) and on-pump coronary artery bypass.Methods 102 patients were randomly divided into three groups:off-pump coronary artery bypass(beating group,n=35),warm blood cardioplegia solution group(warm group,n=32)and cold blood cardioplegia solution group(cold group,n=35). There were no statistical difference in heart function,sex, age and weight before operation.samples were taken to determine the serum concentration of creatine kinase MB isoenzyme (CK-MB)and troponin-T(cTnT),beating group at the induction of anesthesia,then30 min,60min,3h ,6h,12h,24h,3d,5d,7d after the heart performance, warm group and cold group at the induction of anesthesia,then30 min,60min,3h ,6h,12h,24h,3d,5d,7d after the termination cardiopulmonary bypass (CPB). Myocardial ultrastructure was observed in three groups. Results CK-MB, cTnT release in beating group during bypass and post-bypass were lower than those in other groups(P<0.05 or P<0.01),myocardial ultrastructure showed the most excellent in beating group while showed the worst in cold group.Conclusion According to the result of CK-Mb,cTnT,myocardial ultrastructure and clinical manifestation,the myocardial protection effect in beating group has the best effect in myocardial protection while the technique in cold group has the worst effect in three groups. cTNT is more sensitive than CK-MB.