Coronary Artery Disease Clinical Trial
Official title:
Association of Fibrin Clot Properties With Blood Loss Following Coronary Artery By-pass Grafting - Does Surgical Technique of Left Internal Mammary Artery Harvesting Matter
Up to 15% of operations in cardio-pulmonary by-pass are complicated by excessive
postoperative blood loss, which negatively affects the outcomes. Recently, it has been
demonstrated that fibrin clot susceptibility to lysis is a modulator of postoperative blood
loss after cardiac surgery for aortic stenosis. Earlier, a preliminary study showed a
negative association of postoperative blood loss after coronary artery by-pass grafting
(CABG) with fibrin clot lysis time, reflecting susceptibility to fibrinolysis.
In CABG, postoperative blood loss may depend on the operative technique with respect to left
internal mammary artery (LIMA) harvesting. LIMA is taken down in virtually all CABG
procedures, but harvesting technical details remain at surgeons discretion (skeletonization
without opening the pleural cavity vs. pedicled graft with pleura wide open).
The investigators decided to test the hypothesis that fibrin clot properties modulate the
postoperative drainage following CABG strongly enough to attenuate the influence of surgical
technique by randomizing the patients undergoing CABG with regard to LIMA harvesting
technique.
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