A prospective study on indication of intracoronary shunt during off-pump coronary bypass grafting surgery for single-vessel disease

Background: This study aims to investigate whether usage of intracoronary shunt is beneficial in off-pump coronary artery bypass grafting surgery in patients with left anterior descending artery lesion with or without retrograde flow in the vessel. Methods: A total of 80 patients (54 males, 26 females; mean age 61.9 years; range 36 to 82 years) treated with off-pump coronary artery bypass grafting surgery in our clinic between April 2007 and March 2014 were enrolled. While half of the patients had angiographically demonstrated occluded (100%) left anterior descending artery disease, the other half had stenotic left anterior descending artery disease (70-99%). These patients were randomized into four groups according to the degree of obstruction and use of intracoronary shunt. Groups were compared in terms of duration of anastomosis and serum levels of troponin I, creatinine kinase, and creatinine kinase myocardial bundle. Results: Postoperative levels of creatinine kinase myocardial bundle and troponin were significantly lower in the groups in which intracoronary shunt was used. On the contrary, there was no difference in terms of preoperative levels of creatinine kinase myocardial bundle and troponin and preand postoperative levels of creatinine kinase in groups with or without shunt usage. Conclusion: Intracoronary shunt may be advised especially in critically ill patients with anatomical challenges. Further clinical trials are necessary to clarify the indications of intracoronary shunts in off-pump coronary artery bypass grafting surgery.