comparison of serum myocardial biomarkers following two different methods of venoaortic connection in coronary artery bypass grafting: a randomized clinical trial

Background: myocardium will expose to excessive ischemia and reperfusion during post-cardiac surgery, hence the aim of this study was to investigate the cardioprotective effect of sequential partial aortic side biting technique for proximal veno-aortic anastomosis constructions in patients undergoing coronary artery bypass grafting (cabg). methods: in this randomized clinical trial study, 60 consecutive patients who were diagnosed to suffering from triple vessel coronary artery diseases were selected. cabg patients were assigned randomly into two groups; the first group received sooner and gradual myocardial reperfusion one-by-one top end venous anastomosis to the aorta (sequential aortic side biting technique) (n = 30) and the second group undergo proximal anastomoses constructed during a single period of aortic side biting (single aortic side biting technique) (n = 30). the serum levels of myocardial damage biomarkers including creatine phosphokinase-mb (cpk-mb), troponin i, glutathione peroxidase (gpx), superoxide dismutase (sod), malondialdehyde (mda) and catalase (cat) were measured preoperatively, postoperatively and 24 h after operation. independent t- tests was used to compare results between groups. results: the level of all myocardial biomarkers increased after the operation. those in study group had significantly lower levels of troponin i (p < 0.001), cpk-mb (p = 0.001), gpx (p = 0.007), sod (p = 0.005), and cat (p = 0.015), 24h after the operation when compared to control group. only the serum level of cpk-mb was significantly lower in study group after the operation (p = 0.029) while the other markers were comparable. conclusions: sequential partial occluding aortic side biting technique associated with less myocardial damage and ischemiareperfusion injury compared to conventional single method in patients undergoing elective coronary grafting.