Key result
The sequential partial aortic clamp technique significantly reduced the incidence of postoperative atrial fibrillation to 10.3% compared to 41.4% with the partial aortic clamp technique (p=0.007).
Why the study?
The study was conducted to introduce a novel sequential partial aortic clamp technique for proximal anastomoses in CABG.
Does the sequential partial aortic clamp technique reduce myocardial injury and postoperative atrial fibrillation in patients undergoing CABG?
Cohort (n=58)
Open-label
None
No
Does the sequential partial aortic clamp technique reduce myocardial injury and postoperative atrial fibrillation in patients undergoing CABG?
Absolute Event Rate: 10.3% vs 41.4%
p-value: p=0.007
The sequential partial aortic clamp technique during CABG significantly reduces myocardial injury (measured by CK-MB) and the incidence of postoperative atrial fibrillation compared to the standard partial clamp technique.
Hypothesis-generating for sequential partial clamping in CABG; prospective RCTs needed before clinical adoption.
Ischemic heart disease (IHD) is a common and potentially lethal cardiovascular disorder. Coronary artery bypass grafting (CABG) is a standard procedure for treating IHD. This study aims to introduce a novel technique for proximal anastomoses in CABG. This clinical trial studied 29 cases and 29 matched controls. Data were gathered from June 2014 to June 2023. Regarding proximal anastomoses, the sequential partial aortic clamp was performed in cases, and the partial aortic clamp was done for controls. In the sequential partial aortic clamp technique, a relatively small or medium vascular clamp was used instead of one clamp for all proximal anastomoses, which closed a small amount of the aortic wall at each stage. At each stage, only one hole in the aortic wall and only one anastomosis between the conduit and the aorta was performed. After the end of each anastomosis, the clamp was opened and placed on another part of the aorta, and the next anastomosis was performed. CK-MB (p < 0.001, Eta Squared = 0.255) level was significantly lower in cases that underwent sequential partial ascending aorta clamping. However, cTnI level was not statistically different among cases and controls(p = 0.05). Of all patients, 3 (10.3%) cases and 12 (41.4%) controls developed with postoperative atrial fibrillation (p = 0.007). The sequential partial aortic clamp technique leads to less myocardial injury than the partial aortic clamp technique. Also, patients undergoing sequential partial aortic clamp technique are less likely to develop postoperative atrial fibrillation.
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Khajeh et al. (2024) conducted a cohort in Ischemic heart disease requiring CABG (n=58). Sequential partial aortic clamp technique vs. Partial aortic clamp technique was evaluated on Postoperative atrial fibrillation (p=0.007). The sequential partial aortic clamp technique significantly reduced the incidence of postoperative atrial fibrillation to 10.3% compared to 41.4% with the partial aortic clamp technique (p=0.007).
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