CORRELATION BETWEEN EJECTION FRACTION AND CORONARY SINUS BLOOD FLOW DURING OFF-PUMP CORONARY ARTERY BYPASS GRAFTING SURGERY.

Abstract

Introduction: Many studies have shown that coronary artery bypass grafting (CABG) increases the survival rate of patients, but the effect of bypass grafting on cardiac function is still a matter of debate.

Objective: The objective of our study was to determine: a. To what extent can the change in coronary sinus flow be used as an intraoperative criterion for the assessment of adequate revascularization. b. Whether the functional improvement of the revascularized myocardium occurs. c. The existence of a correlation between the change in coronary sinus flow and changes in myocardial function.

Material and methods: Our study included 435 adult patients of both sexes, aged 55-85 years, ASA -III or less, who underwent coronary artery bypass grafting on a functioning heart. For this part of the study, 70 patients were selected, in whom ejection fraction (EF) and coronary sinus blood flow (CSBF) were determined before and after bypass grafting by transesophageal echocardiography (TEE).

Results: CSBF flow in the CS increases in 74% of cases after bypass surgery, does not change in 9% of cases, and decreases in 17% of cases. Based on the results obtained, ΔFlow and ΔEF - this distribution is not reliable (Сhi2=2.76, p=0.599, NS) There is no reliable correlation between intraoperative CSBF and EF.

Conclusions: In off-pump CABG-surgery, CSBF increases in most cases when assessed shortly after revascularization. In cases where an increase in EF was observed, CSBF did not increase in most cases and vice versa, meaning that CSBF and cardiac EF did not correlate in the immediate post-revascularization period.