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Ann Thorac Surg 1999;67:1721-1725
© 1999 The Society of Thoracic Surgeons

Original Articles

Release of S100B during coronary artery bypass grafting is reduced by off-pump surgery

Russell E. Anderson, MD, PhDa, Lars-Olof Hansson, MD, PhDb, Jarle Vaage, MD, PhDc

a Departments of Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden
b Department of Clinical Chemistry, Karolinska Hospital, Stockholm, Sweden
c Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden

Accepted for publication December 30, 1998.

Address reprint requests to Dr Anderson, Department Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, S-171 76 Stockholm, Sweden
e-mail: russell.anderson{at}kirurgi.ki.se

Background. S100B, a plasma marker of brain injury, was compared after coronary artery bypass grafting with and without cardiopulmonary bypass (CPB).

Methods. Fourteen patients with off-pump operations and 18 patients with CPB were compared. Seven patients in the off-pump group underwent a minithoracotomy and received only an arterial graft, whereas 7 patients underwent sternotomy and received both an arterial and one or two vein grafts. S100B was measured in arterial plasma using an immunoassay with enhanced sensitivity.

Results. S100B before the operation was 0.03 µg/L. At wound closure, S100B in patients of the off-pump and CPB groups reached a maximum level of 0.22 ± 0.07 and 2.4 ± 1.5 µg/L, respectively (p < 0.001). No strokes occurred. Patients without CPB receiving arterial and vein grafts released slightly more S100B (p < 0.05) than patients with only arterial grafting. In patients undergoing CPB, S100B increased slightly before aortic cannulation (p < 0.001), to the same level as the maximum reached for the non-CPB group.

Conclusions. Coronary artery bypass grafting with CPB caused a 10-fold greater increase in S100B than off-pump grafting. S100B release after off-pump sternotomy with vein grafting was slightly greater than in arterial grafting through a minithoracotomy.




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