Comparison of hemodynamics and myocardial zymogram in elderly patients receiving off-pump versus on-pump coronary artery bypass grafting perioperatively
10.3760/cma.j.issn.0254-9026.2013.01.005
- VernacularTitle:老年患者不同术式冠状动脉旁路移植围术期心脏泵血功能和对心肌影响的程度比较
- Author:
Huaibin WANG
;
Wenjun ZHEN
;
Xiaokang OUYANG
;
Yujian MA
;
Jie TAN
;
Wenqi LUO
- Publication Type:Journal Article
- Keywords:
Coronary artery bypass,off-pump;
Intraoperative period;
Troponin;
Creatine kinase
- From:
Chinese Journal of Geriatrics
2013;(1):18-21
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes of hemodynamics,cardiac troponin T(cTNT) and CK-MB zymogram perioperatively in elderly patients receiving off-pump versus on-pump coronary artery bypass grafting (CABG).Methods Totally 40 elderly patients (age＞65 years) undergoing surgical revascularization in our hospital were reviewed.20 patients were received off-pump coronary artery bypass grafting (group A),20 patients received on-pump surgery (group B).The cardiac output index (CI) and systemic vascular resistance index (SVRI) of each patient were recorded at the time of preoperative (T1),surgery completion (T2) and first day after surgery (T3).cTNT and CKMB of all patients were detected perioperatively.Results The level of CI was increased after operation,whereas CI of group A in T2 was significantly higher than that of group B [(3.92±0.43) L· min-1 · m-2 & (3.81±0.52)L · min 1 · m-2,t=2.036,P＜0.05).SVRI was decreased after operation,there was no difference between the two groups during the same time (P＞0.05).The levels of cTNT and CK-MB were within normal range before operation,whereas enhanced immediately after operation and returned to normal within the 7th day.The level of CK-MB in group B after operation was higher than that in group A [(11.8±4.4)tμg/L vs.(8.4±4.3)μg/L,t=2.214,P＜0.05) ；The level of cTNT in group B at 1st day after operation was increaesd compared with that in group A [(0.23±0.12)μg/L vs.(0.l1±0.09)μg/L],t=2.189,P＜0.05).Conclusions Both off-pump and on-pump CABG could improve the cardiac output and get approving myocardial protection effects in elderly patients,the effect of off-pump CABG might be superior to that of onpump CABG comparatively.
