Brazilian journal of cardiovascular surgery最新文献

{"title":"Minimally Invasive Cardiac Surgery: Sternal Incision Size vs. Extracorporeal Circulation Time and Other Factors.","authors":"Mesut Engin, Mustafa Abanoz, Ahmet Kagan As, Umut Serhat Sanrı","doi":"10.21470/1678-9741-2024-0090","DOIUrl":"10.21470/1678-9741-2024-0090","url":null,"abstract":"","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the Charlson Comorbidity Index in the Preoperative Evaluation of Patients Undergoing Cardiac Surgery.","authors":"Daniel Manzur-Sandoval, Monserrat Echeverria-Ortuño, Rodrigo Gopar-Nieto, Gustavo Rojas-Velasco","doi":"10.21470/1678-9741-2025-0151","DOIUrl":"10.21470/1678-9741-2025-0151","url":null,"abstract":"<p><strong>Introduction: </strong>The Charlson Comorbidity Index (CCI) is used for assessing comorbidities and estimating risk of adverse outcomes in surgical patients. In cardiac surgery, the burden of comorbidities can significantly influence incidence of postoperative complications and mortality. This study evaluates the utility of CCI in predicting perioperative complications in patients undergoing cardiac surgery.</p><p><strong>Methods: </strong>Observational cross-sectional study with retrospective data including 483 adult patients who underwent cardiac surgery with cardiopulmonary bypass at the Instituto Nacional de Cardiología Ignacio Chávez from June 2022 to December 2023. Patients were grouped by preoperative CCI: mild (0 - 1), moderate (2), and severe (≥ 3). Statistical analyses (chi-square, Mann-Whitney U, logistic regression) assessed the association between CCI and postoperative complications, adjusting for age and sex.</p><p><strong>Results: </strong>Patients with severe comorbidity had higher rates of postoperative complications, including delirium (27.3% vs. 9.4%, P = 0.00), stroke (P = 0.03), transfusion (69.7% vs. 47.2%, P = 0.04), and renal replacement therapy (18.2% vs. 5.3%, P = 0.02). Median Sequential Organ Failure Assessment scores at 24 hours were significantly higher (P = 0.00). Logistic regression adjusted for age, sex, and coronary artery bypass grafting identified delirium (odds ratio [OR]: 3.13), nosocomial pneumonia (OR: 3.10), acute kidney injury (OR: 2.28), and renal replacement therapy (OR: 4.10) as independent predictors of severe comorbidity.</p><p><strong>Conclusions: </strong>The CCI is a valuable tool for predicting postoperative complications in patients undergoing cardiac surgery. Early identification of comorbidities is essential for perioperative planning and optimizing clinical outcomes. Integrating the CCI into routine clinical practice is recommended to enhance patient management.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the Optimal Parameters for Scoring Systems to Predict Postoperative Bleeding After Diabetic Coronary Artery Bypass Surgery.","authors":"Engin Akgul, Abdulkerim Ozhan","doi":"10.21470/1678-9741-2022-0178","DOIUrl":"10.21470/1678-9741-2022-0178","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative bleeding increases morbidity and mortality. We aimed to review the scoring systems used to predict massive bleeding after isolated coronary artery bypass grafting in diabetic patients and determine the parameters of the new scoring system - the Optimum Risk Score for Bleeding (ORS).</p><p><strong>Methods: </strong>Two hundred ninety-seven diabetic patients who underwent isolated coronary artery bypass operation between 2017 and 2019 were reviewed. The patients were grouped according to amount of drainage (> 850 mL/day) and the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) bleeding severity grade. Previously identified risk factors and scoring systems (Papworth, WILL-BLEED, Association of Cardiothoracic Anesthetists perioperative risk of blood transfusion [ACTA-PORT], Transfusion Risk and Clinical Knowledge [TRACK], and Transfusion Risk Understanding Scoring Tool [TRUST]) were analyzed.</p><p><strong>Results: </strong>Papworth was better predictive for E-CABG bleeding grades 2 - 3. WILL-BLEED, ACTA-PORT, TRACK, and TRUST had no discriminatory value in terms of E-CABG bleeding grades 2 - 3. Among the parameters in the scoring systems, gender, preoperative hemoglobin (or hematocrit) value, preoperative platelet count, use of antiplatelets until less than five days prior to the operation, and preoperative creatinine (or estimated glomerular filtration rate) values should be included in the scoring system we aim to establish in the future, the ORS.</p><p><strong>Conclusion: </strong>The current scoring systems do not provide satisfactory results in predicting postoperative bleeding. Female gender, lower body mass index, and preoperative platelet count were associated with increased postoperative bleeding. There is a need for an ORS which gives more precise results in predicting postoperative bleeding.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Transplantation and Cold Ischemia: Towards Crossing the Border?","authors":"Elvis Aaron Porto, Marcello Laneza Felicio, Antônio Sérgio Martins, Luana Monferdini, Flávio de Souza Brito, Leonardo Rufino Garcia","doi":"10.21470/1678-9741-2024-0438","DOIUrl":"10.21470/1678-9741-2024-0438","url":null,"abstract":"<p><strong>Introduction: </strong>Heart transplantation is a crucial therapeutic modality for patients with advanced heart failure. For satisfactory results, acceptable ischemic times are essential. This study aims to investigate the relationship between cold ischemic time > 4 hours and mortality in the first month after heart transplantation.</p><p><strong>Methods: </strong>Retrospective and observational analysis of medical records of patients who underwent heart transplantation between January 2019 and December 2023. The inclusion criteria were patients who underwent heart transplantation using the histidine-tryptophan-ketoglutarate preservation solution during organ retrieval and immediately before organ implantation. Recipient variables, etiology of heart failure, procedural variables, and 30-day mortality were studied.</p><p><strong>Results: </strong>During the study period, 62 patients underwent heart transplantation. There were a predominance of males (79%) and an average age of 51 years. Seven patients had a cold ischemic time ≥ 4 hours, with three dying (43%) before 30 days. Among the 55 patients with cold ischemic times < 4 hours, 17 died (31%) before 30 days. Statistical analysis using the chi-square test revealed no statistically significant association between cold ischemia and mortality in the first 30 days after transplantation (P = 0.835).</p><p><strong>Conclusion: </strong>The study found no difference in 30-day mortality between patients who underwent heart transplantation with cold ischemic times > 4 hours and those with cold ischemic times < 4 hours. Thus, there may be new strategies to increase the number of donors with a safe rebalance of the relationship between the number of available allografts and patients on the waiting list.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Jackson-Pratt Mediastinal Drains in Reducing Pericardial Effusion and Atrial Fibrillation After Coronary Artery Bypass Grafting: A Retrospective Cohort Study.","authors":"Mehmet Ali Yuruk, Ahmet Coşkun Özdemir","doi":"10.21470/1678-9741-2025-0277","DOIUrl":"10.21470/1678-9741-2025-0277","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative complications such as pericardial and pleural effusions, cardiac tamponade, and atrial fibrillation (AF) are common after coronary artery bypass grafting (CABG). While standard chest tubes are routinely used for drainage, Jackson-Pratt drains (JP-D) may offer advantages due to their flexible design and ability to maintain negative pressure.</p><p><strong>Methods: </strong>This retrospective study compared outcomes between patients who received conventional chest tubes drains (CT-D group) (n = 672; 2016 - 2020) and those who received JP-D in addition to standard drains (JP-D group, n = 706; 2020 - 2023) after CABG. Demographic, operative, and postoperative data were collected and analyzed.</p><p><strong>Results: </strong>Both groups were similar in baseline characteristics (P > 0.05 for all). The JP-D group had significantly lower rates of cardiac tamponade (0.28% vs. 1.78%, P = 0.008), reoperation (1.55% vs. 4.61%, P = 0.001), wound infections (2.1% vs. 4.1%, P = 0.024), 30-day mortality (1.1% vs. 2.0%, P = 0.035), and postoperative AF (9.2% vs. 16.8%, P = 0.039). Despite a higher first-day drainage volume (480 ± 150 mL vs. 360 ± 120 mL, P = 0.030), total drainage volume was similar. Pulmonary complications, including atelectasis and pneumonia, were also significantly reduced in the JP-D group.</p><p><strong>Conclusions: </strong>The use of JP-D in conjunction with standard thoracic drainage after CABG was associated with improved postoperative outcomes, including reduced effusion-related complications and AF. These findings suggest potential benefits of JP-D in cardiac surgery, though prospective studies are warranted to confirm these results.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrinsicoid Deflection of the QRS Complex Predicts Appropriate Antitachycardia Pacing or Shock Therapy in Heart Failure Patients with an Implantable Cardioverter Defibrillator.","authors":"Meltem Altınsoy, İsmail Adsız, Hamza Sunman, Çagatay Tunca, Funda Basyigit","doi":"10.21470/1678-9741-2025-0081","DOIUrl":"10.21470/1678-9741-2025-0081","url":null,"abstract":"<p><strong>Introduction: </strong>Sudden cardiac death remains a significant risk for patients with heart failure (HF). Current guidelines recommend implantable cardioverter defibrillator (ICD) for patients with low left ventricular ejection fraction (LVEF). However, the effectiveness and necessity of ICDs in patients with normal LVEF raise questions, especially given associated complications and costs.</p><p><strong>Objective: </strong>This study aims to evaluate the electrocardiographic predictors of appropriate ICD therapy (antiTachycardia pacing [ATP]/shocks) in patients with HF.</p><p><strong>Methods: </strong>We conducted an analysis of 160 consecutive HF patients (New York Heart Association class I-III, LVEF ≤ 35%) undergoing ICD controls from January 2023 to December 2024. Patients were classified into two groups based on the occurrence of appropriate ATP or ICD shocks. Electrocardiographic parameters including QRS duration, QTc interval, intrinsicoid deflection (ID), and fragmented QRS (fQRS) were assessed. Statistical analyses, including receiver operating characteristic curves and logistic regression, were performed to identify independent predictors of appropriate ICD therapy.</p><p><strong>Results: </strong>The ATP/shock group exhibited significantly prolonged QRS and QTc intervals, increased ID, and higher Selvester scores compared to the non-shock group. Notably, an ID > 50 ms emerged as a strong predictor of ICD therapy (sensitivity 96.3%, specificity 95.3%). Univariate and multivariate analyses identified ID, fQRS, and Selvester score as independent predictors of appropriate ICD therapy.</p><p><strong>Conclusion: </strong>Elevated ID, alongside other electrocardiographic parameters, serves as a valuable predictor for appropriate ICD therapy in HF patients. These findings support the potential for refining ICD implantation criteria, emphasizing the importance of detailed electrocardiographic evaluation in predicting arrhythmic events.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Memoriam: Professor Enio Buffolo (1941 - 2025).","authors":"Ricardo de Carvalho Lima, José Wanderley Neto, José Teles de Mendonça, Paulo Roberto Brofman, Fernando Antonio Lucchese, Fabio B Jatene, José Medina Pestana, Tomas Salerno","doi":"10.21470/1678-9741-2025-0409","DOIUrl":"https://doi.org/10.21470/1678-9741-2025-0409","url":null,"abstract":"<p><p>Professor Enio Buffolo, born on Dezember 9th, 1941, was a pioneer in thoracic and cardiovascular surgery in Brazil. His career spanned over six decades, during which he made groundbreaking contributions to world cardiac surgery, including the development of off-pump coronary artery bypass, endovascular treatment of aortic aneurysms, and the introduction of transcatheter aortic valve implantation in Brazil. He held numerous leadership roles, mentored generations of surgeons, and published extensively. His legacy is defined by visionary leadership, academic excellence, and deep humanistic values that continue to shape cardiovascular medicine in Brazil and beyond. If unanimous opinions are rare, just as rare are those that serve as examples, in their most diverse conducts, for family, friends, and coworkers. Dr. Enio Buffolo has a special place among this category of citizenship and humanism.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-term Outcomes of Transcatheter Aortic Valve Replacement vs. Surgical Aortic Valve Replacement in Low-to-Moderate Risk Patients with Severe Aortic Stenosis: A Systematic Review and Meta-analysis.","authors":"Capela António Dicazeco Pascoal, Hilária Saugo Faria, Antonino de Jesus Francisco, Clara de Andrade Pontual Peres, Luiz Fernando Tavares, Barbara Bombassaro Masiero, Mohamed Doma, Valdano Manuel","doi":"10.21470/1678-9741-2024-0250","DOIUrl":"10.21470/1678-9741-2024-0250","url":null,"abstract":"<p><strong>Introduction: </strong>Several clinical trials have demonstrated the non-inferiority of transcatheter aortic valve replacement compared with surgical aortic valve replacement in patients with severe aortic stenosis and low to intermediate surgical risk. However, mid-term results are still contentious. We performed this meta-analysis to compare the safety and efficacy of transcatheter vs. surgical aortic valve replacement in the mid-term in patients with aortic stenosis at low to moderate surgical risk.</p><p><strong>Methods: </strong>We searched Embase, PubMed®, and Cochrane databases for randomized clinical trials that compared transcatheter with surgical aortic valve replacement in patients with symptomatic severe aortic stenosis with a follow-up of at least four years. Outcomes of interest were all-cause mortality and disabling stroke.</p><p><strong>Results: </strong>We included six randomized clinical trials encompassing 6,444 patients with severe aortic stenosis, of whom 3,282 (50.9%) underwent transcatheter aortic valve replacement. There was no difference in all-cause mortality (risk ratio [RR] 1.08; 95% confidence interval [CI] 0.94 - 1.25; P = 0.30) and disabling stroke (RR 0.95; 95% CI 0.75 - 1.21; P = 0.67) between groups. In the subgroup analysis, five-year mortality (RR 1.28; 95% CI 1.10 - 1.49) was higher in the transcatheter group. The new pacemaker implantation (RR 2.22; 95% CI 1.42 - 3.45) rate was higher in the transcatheter group. However, the new atrial fibrillation (RR 0.40; 95% CI 0.31 - 0.52) rate was higher in the surgical group.</p><p><strong>Conclusion: </strong>Mid-term mortality and disabling stroke rates in patients with severe aortic stenosis treated with either transcatheter or surgical aortic valve replacement were similar.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12599829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between the Serum Aspartate Aminotransferase/Alanine Aminotransferase Ratio and the Occurrence and Progression of Abdominal Aortic Aneurysms: A Cross-Sectional Study.","authors":"Hande İştar, Bugra Harmandar, Melike Korkmaz Toker, Gokhan Ilhan, Kadir Arslan, Muruvvet Funda Tetik Saruhan","doi":"10.21470/1678-9741-2025-0157","DOIUrl":"10.21470/1678-9741-2025-0157","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the relationship between the serum aspartate aminotransferase to alanine aminotransferase (AST/ALT) ratio, the presence and progression of abdominal aortic aneurysms (AAA), assessing its potential as an accessible biochemical marker for patients at risk of rapid aneurysmal growth.</p><p><strong>Methods: </strong>A total of 180 patients were retrospectively analyzed: 90 with AAA and 90 ageand risk factor-matched controls. Demographic characteristics, risk factors, laboratory parameters, and imaging data were reviewed. The AAA group was divided into rapid and slow enlargement subgroups based on six-month computed tomography measurements. Logistic regression, receiver operating characteristic (ROC) analyses were used to evaluate predictive and discriminative performance, and quartile analysis explored potential threshold effects.</p><p><strong>Results: </strong>AST/ALT ratio, triglycerides, low-density lipoprotein (LDL) cholesterol, and white blood cell (WBC) count were significantly higher in patients with AAA. Rapid AAA enlargement group had higher AST/ALT ratios, triglycerides, LDL cholesterol, and WBC counts. The AST/ALT ratio was independently associated with AAA presence (odds ratio 2.63; 95% confidence interval [CI] 1.44 - 5.09; P = 0.002) but not with rapid progression (P = 0.10). ROC analysis showed good discrimination for AAA presence (area under the curve [AUC] = 0.72; 95% CI 0.65 - 0.79) and moderate ability for rapid enlargement (AUC = 0.65; 95% CI 0.54 - 0.76). Quartile-based analysis revealed a stepwise increase in AAA prevalence with higher AST/ALT categories.</p><p><strong>Conclusion: </strong>An elevated AST/ALT ratio is associated with AAA presence but does not independently predict progression, suggesting it reflects hepatic-vascular inflammatory interaction rather than serving as a prognostic marker.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial Damage and Inflammatory Response After Cardiac Surgical Revascularization on Beating and Arrested Heart.","authors":"Ante Bosnjak, Igor Rudez, Gordan Galic, Hrvoje Mikulic, Miro Mandic, Josko Petricevic","doi":"10.21470/1678-9741-2024-0152","DOIUrl":"10.21470/1678-9741-2024-0152","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery bypass grafting remains the preferred method for surgical myocardial revascularization. The use of extracorporeal circulation during surgery has been linked to myocardial damage and a systemic inflammatory response. To mitigate these adverse effects, off-pump coronary artery bypass grafting was introduced as an effective and safe alternative. However, the comparison between these two procedures has yielded ambiguous results. The aim of our study was to determine the differences in myocardial damage and the intensity of the inflammatory response by measuring concentrations of troponin, cardiac isoenzyme of creatine kinase, leukocytes, and C-reactive protein at multiple time points within the first 24 hours postoperatively.</p><p><strong>Methods: </strong>This single-center, prospective study involved 61 patients diagnosed with coronary artery disease and divided into two groups based on the type of surgery performed.</p><p><strong>Results: </strong>Our results indicated that coronary artery bypass grafting with extracorporeal circulation is associated with greater myocardial damage, as evidenced by higher levels of troponin and cardiac isoenzyme of creatine kinase. Additionally, extracorporeal circulation was linked to a more pronounced increase in leukocyte count postoperatively. Unexpectedly, C-reactive protein levels were higher in the off-pump coronary artery bypass grafting group. There were no significant differences in hospital stay or in-hospital mortality between the two groups.</p><p><strong>Conclusion: </strong>Further research is necessary to clarify these controversies regarding the differences in systemic inflammatory responses between the two surgical approaches.</p>","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":"41 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12661970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}