Differential effects of single versus double aortic clamping on myocardial protection during coronary bypass.

The effects of double (n = 60, group 1) versus single (n = 60, group 2) aortic clamping on myocardial function and protection were investigated during coronary artery bypass grafting using a heart-lung pump. In group 1, after opening the cross clamp, proximal anastomosis was completed using side clamps and, in group 2, distal and proximal anastomosis was completed with a single clamp. Cross clamping time in the single-clamp patients (group 2; 77.1 min) was significantly higher than in the double-clamp patients (group 1; 62.9 min). Troponin T was significantly higher in group 2 than in group 1 h and 24 h after surgery. Post-operative left ventricular ejection fraction decreased in both groups, but this was not statistically significant. Post-operative wall motion score index and myocardial performance index increased significantly in both groups compared with the pre-operative level. Overall, the double-clamp technique provided better myocardial protection than the single-clamp technique and neither technique seemed to have a negative impact on the early post-operative global functioning of the left ventricle, however the effect of these techniques on the global functioning of the left ventricle in the late postoperative period needs to be evaluated.

RCT Entities:   Population Interventions Outcomes