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Effect of intracoronary shunt on right ventricular function during off-pump grafting of dominant right coronary artery with poor collateral

 Jae-Kwang Shim  ;  Sou-Ouk Bang  ;  Jong-Hwa Lee  ;  Young-Jun Oh  ;  Kyung-Jong Yoo  ;  Young-Lan Kwak 
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.23(3) : 373-377, 2008 
Journal Title
Issue Date
Aged ; Blood Pressure ; Collateral Circulation* ; Coronary Artery Bypass, Off-Pump/methods* ; Coronary Artery Disease/physiopathology ; Coronary Artery Disease/surgery* ; Coronary Circulation* ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Norepinephrine/administration & dosage ; Prospective Studies ; Stroke Volume ; Sympathomimetics/administration & dosage ; Thermodilution ; Ventricular Function, Right*
Coronary Artery Bypass ; Off-Pump ; Shunt ; Coronary Artery ; Ventricular Function, Right
Although numerous studies have validated the efficacy of intracoronary shunt on reducing left ventricular dysfunction during off-pump coronary artery bypass surgery (OPCAB), there is lack of evidence supporting its role on right ventricular (RV) function during right coronary artery (RCA) revascularization. Therefore, we studied the effect of intracoronary shunt during grafting of dominant RCA without visible collateral supply on global RV function using thermodilution method. Forty patients scheduled for multivessel OPCAB with right dominant coronary circulation without collateral supply confirmed by angiography were randomized to RCA revascularization either with a shunt (n=20) or soft snare occlusion (n=20). RV ejection fraction (RVEF) was recorded at baseline, during RCA grafting, and 15 min after reperfusion. Corresponding RV stroke work index (RVSWI) was calculated. RVEF and RVSWI decreased significantly during RCA grafting and returned to baseline values after reperfusion in both groups without any significant differences between the groups. Intracoronary shunt did not exert any beneficial effect on global RV function during RCA grafting, even in the absence of visible collateral supply. Regarding the possibility of graft failure by intracoronary shunt-induced endothelial damage, routine use of intracoronary shunt during RCA grafting is not recommended in patients with preserved biventricular function.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Bang, Sou Ouk(방서욱)
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lee, Jong Wha(이종화)
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