Off-Pump and On-Pump Techniques and Oxidative Stress in CABG Surgery
Condition: Cerebral Oxygenation; Oxidative Stress; Myocardial Infarction
MeSH terms: Myocardial Infarction; Infarction
Study type: Observational [Patient Registry]

Summary: 
      CABG (coronary artery bypass graft) surgery is among the most common heart surgeries
      performed in the heart pump. In CABG surgery, operations performed on the beating heart
      without the use of CPB (off-pump) are frequently performed (30-60%) (1).

      To the best of our knowledge, there has been no study examining cerebral oxygenation values,
      oxidative stress levels and postoperative results in CABG operations.
    

Detailed description: 
      CABG (coronary artery bypass graft) surgery is among the most common heart surgeries
      performed in the heart pump. In CABG surgery, operations performed on the beating heart
      without the use of CPB (off-pump) are frequently performed (30-60%) (1). Off-pump coronary
      artery bypass surgery is also called beating-heart surgery, and its purpose is to avoid
      cardiopulmonary bypass completely without the support of a heart lung machine, thereby
      avoiding its adverse effects (3-5). It has been reported that the off-pump CPB surgical
      method is associated with a decrease in the incidence of early stage and major complications
      compared to the traditional CPB method (2). Exposure to surgical stress leads to autonomic,
      visceral, and immunological responses, leading to oxidative stress, neurochemical and
      hormonal abnormalities (3).In addition to the non-physiological hemodynamic conditions that
      occur during CABG surgery, a significant increase is observed in inflammatory response and
      oxidative stress biomarkers due to surgical trauma, cardiopulmonary bypass (CPB) and organ
      reperfusion injury (4).For this reason, it is important to detect the presence and severity
      of postoperative adverse outcomes after CABG early. To the best of our knowledge, there has
      been no study examining cerebral oxygenation values, oxidative stress levels and
      postoperative results in CABG operations.

      This prospective observational study is planned to include 64 adult patients aged 30-80 years
      who will undergo CABG surgery. Patients will be grouped according to the surgical technique
      (on-pump and off-pump) determined (indicated) according to the cardiovascular risk status of
      the patient by the Cardiovascular Surgery department.

      Patients' perioperative cerebral hemoglobin oxygen saturations will be recorded with the
      Regional Oximeter (non-invasive cerebral oxygenation measurement device).

      In patients undergoing On-Pump bypass, at the beginning of the CABG surgery (basal), during
      the aortic clamp, 15 minutes after the clamp is lifted, the remaining 3 ml of blood will be
      centrifuged at 3000 rpm for 5 minutes and the serum part will be separated.

      In off-pump bypass surgery patients, 3 ml of blood will be centrifuged at the beginning of
      the operation, at the beating phase and 15 minutes after the beating process is completed.

      Total antioxidant status, Total oxidant status, Superoxide dismutase, Malondialdehyde will be
      measured in the Enzyme-Linked ImmunoSorbent Assay device from blood samples taken from all
      patients in the study, and their concentrations will be determined.
    

Intervention name(s): On-Pump CABG; Off-Pump CABG
Intervention type(s): Procedure; Procedure
Intervention description(s): Patients who have undergone on-pump Coronary artery bypass grafting (CABG) surgery are planned by the Department of Cardiovascular Surgery.; Patients who have undergone off-pump Coronary artery bypass grafting (CABG) surgery are planned by the Department of Cardiovascular Surgery.
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        It is planned to participate in this prospective observational study of 64 volunteer
        patients undergoing Coronary artery bypass grafting (CABG) surgery by the Department of
        Cardiovascular Surgery.
      
Keywords: Coronary artery bypass surgery; Oxidative stress; Cerebral oxygenation