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Naresh Trehan
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Ann Thorac Surg 2006;82:1559-1566
© 2006 The Society of Thoracic Surgeons

Reviews

Controversies in the Use of Intraluminal Shunts During Off-Pump Coronary Artery Bypass Grafting Surgery

Sathiakar Paul Collison, DNB*, Anil Agarwal, MCh, Naresh Trehan, MD

Escorts Heart Institute and Research Centre, New Delhi, India

* Address correspondence to Dr Collison, Escorts Heart Institute and Research Centre, Okhla Rd, New Delhi, India 110025 (Email: spcollison{at}gmail.com).

Technical advances have made the performance of multivessel off-pump coronary artery bypass feasible. Snaring and intraluminal shunts are the techniques used for vascular control. Snaring provides a bloodless surgical field, is usually well tolerated by the patient, and is supported by years of clinical experience. Intraluminal shunts aim to achieve hemostasis at the arteriotomy site and to allow antegrade flow to provide myocardial protection. There are unresolved issues regarding whether shunts have a clinical benefit, do provide adequate flow to provide myocardial protection, and whether they cause significant endothelial damage. In this article, we have reviewed the literature to lend perspective to these issues.




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A. Rukosujew, S. Klotz, C. Reitz, W. Gogarten, H. Welp, and H. H. Scheld
Patients and complication with off-pump vs. on-pump cardiac surgery a single surgeon experience
Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 768 - 771.
[Abstract] [Full Text] [PDF]


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