The Relation between the Mean Time Interval of Opening of Aortic Cross Clamp to the End of Cardiopulmonary Bypass with Surgical Results of Patient after Coronary Artery Bypass Grafting Surgery

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Cardiovascular Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Extracorporeal Technology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Coronary artery bypass graft surgery combined with cardiopulmonary bypass causes changes in body physiology. In the meantime, aortic cross clamp time and cardiopulmonary bypass have been implicated in surgical outcomes. The purpose of this study was to determine the association between mean duration of aortic cross clamp opening to end of cardiopulmonary bypass with surgical outcome of patients after coronary artery bypass graft surgery (CABG).Methods: This was a descriptive cross-sectional study on 47 patients with age range of 40 to 65 years who underwent CABG surgery in Shahid Chamran hospital, Isfahan, Iran; they were selected using non-random sampling method over a 5-month period in 2019. In these patients, the aortic-clamp opening period was measured until the end of cardiopulmonary bypass, and evaluated for surgical outcomes such as death, atrial fibrillation, mechanical ventilation time, troponin and creatine kinase-MB (CKMB) levels before surgery, and 12, 24, and 48 hours after it, as well as the length of intensive care unit (ICU) stay.Findings: There was no significant relationship between the mean duration of aortic cross clamp opening to end of cardiopulmonary bypass with death, atrial fibrillation, preoperative and 12, 24, and 48 hours postoperative CKMB level, and ICU stay. Moreover, there was a significant relationship between this time period and preoperative and 12, 24, and 48 hours postoperative troponin levels and the duration of lung mechanical ventilation.Conclusion: Extending the interval time of opening aortic cross clamp ton the end of the cardiopulmonary bypass, raised the mechanical lung ventilation time. By reducing the duration of this interval, the duration of mechanical ventilation and postoperative pulmonary complications can be reduced.

Keywords

References

  1. Rigi F, Feizi A, Naseri M, Salehi Ardabili S, Bazdar P. The effect of foot reflexology on anxiety in patients with coronary artery bypass surgery referred to Seyed-Al-Shohada Teaching Hospital, Urmia, 2012. J Urmia Nurs Midwifery Fac 2013; 11(8): 578-83. [In Persian].
  2. Sadeghi Meibodi A. Investigation the Outcomes of CABG in Patients with left ventricular dysfunction. J Guilan Univ Med Sci 2010; 19(73): 97-102. [In Persian].
  3. Wang S, Lv S, Guan Y, Gao G, Li J, Hei F, et al. Cardiopulmonary bypass techniques and clinical outcomes in Beijing Fuwai Hospital: A brief clinical review. ASAIO J 2011; 57(5): 414-20.
  4. Cossu AP, Suelzu S, Piu P, Orecchioni M, Bazzu G, Padua G, et al. Do on- and off-pump coronary bypass surgery differently affect perioperative peripheral tissue metabolism? Minerva Anestesiol 2012; 78(1): 26-33.
  5. Corral-Velez V, Lopez-Delgado JC, Betancur-Zambrano NL, Lopez-Sune N, Rojas-Lora M, Torrado H, et al. The inflammatory response in cardiac surgery: An overview of the pathophysiology and clinical implications. Inflamm Allergy Drug Targets 2015; 13(6): 367-70.
  6. Rajabi M, Safarpoor G, Borzou SR, Farhadian M, Arabi A, Moeinipour A, et al. Association between incidence of atrial fibrillation and duration of cardiopulmonary bypass in coronary artery bypass graft surgery (CABG): A cohort study. Electron Physician 2018; 10(4): 6624-30.
  7. Nissinen J, Biancari F, Wistbacka JO, Peltola T, Loponen P, Tarkiainen P, et al. Safe time limits of aortic cross-clamping and cardiopulmonary bypass in adult cardiac surgery. Perfusion 2009; 24(5): 297-305.
  8. Chalmers J, Pullan M, Mediratta N, Poullis M. A need for speed? Bypass time and outcomes after isolated aortic valve replacement surgery. Interact Cardiovasc Thorac Surg 2014; 19(1): 21-6.
  9. Al-Sarraf N, Thalib L, Hughes A, Houlihan M, Tolan M, Young V, et al. Cross-clamp time is an independent predictor of mortality and morbidity in low- and high-risk cardiac patients. Int J Surg 2011; 9(1): 104-9.
  10. Hasanshiri F, Pourabbasi M, Rezaee Moghadam A, Moosavi G, Fattahi M, Motamednejad A. The effect of pulmonary ventilation during cardiopulmonary bypass (CPB) on pulmonary outcomes and complications after coronary artery bypass graft. J Anesth Pain 2017; 7(3): 25-37. [In Persian].
  11. Torabian S, Karimi AA, Sedaghat Siahkal M, Mandegar MH. One-month survival after coronary artery bypass graft (CABG). Payesh 2009; 8(1): 5-10. [In Persian].
  12. Askari B, Mehdizadeh H, Koomasi S. Evaluation of determinants of mortality in patients undergoing coronary artery bypass graft surgery in Urmia Seyed-al-Shohada Heart Center. Razi J Med Sci 2019; 25(11): 23-33. [In Persian].
  13. Thoren E, Hellgren L, Stahle E. High incidence of atrial fibrillation after coronary surgery. Interact Cardiovasc Thorac Surg 2016; 22(2): 176-80.
  14. Nakhostin Davari P, Savad Kouhi S, Shahraki K, Emamdadi A. Cardiac troponin I level before and after elective open heart surgery in pediatrics. J Isfahan Med Sch 2010; 27(101): 710-6. [In Persian].
  15. Mohamed AS, Azzam ME, Lamlom AH, Abo Senna WG, Sewielam MI, Kandeel TM. The effect of the cross clamp time on the post operative ventilation in post CABG patients. J Adv Pharm Edu Res 2017; 7(4): 414-9.
  16. Madhavan S, Chan SP, Tan WC, Eng J, Li B, Luo HD, et al. Cardiopulmonary bypass time: Every minute counts. J Cardiovasc Surg (Torino) 2018; 59(2): 274-81.
Journal of Isfahan Medical School
Volume 37, Issue 550 - Serial Number 550
September and October 2020
Pages 1220-1225

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History

  • Receive Date: 26 September 2019
  • Revise Date: 25 May 2024
  • Accept Date: 06 April 2022

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