مقايسه دو روش تك كلمپي و چند كلمپي در كاهش سكته مغزي در بيماران نيازمند به عمل باي پس كرونر (CABG)

Comparison of Single Cross-Clamp versus Multiple Clamp Technique in Reducing the Incidence of Stroke for Patients Undergoing Coronary Artery Bypasses Grafting (CABG)

Background and Objective: Stroke and cognitive impairment after coronary artery bypass grafting (CABG) are associated with cerebral embolization. An important cause of embolism is manipulation of the ascending aorta. There are two distal and proximal anastomosis in CABG that can be done by single cross-clamp or by on cross-clamp and one side-biting clamp on ascending aorta. The later is done for reducing cardiac ischemia. Single clamp technique may be associated with lesser cerebral injury. The Aim of study is survey of surgical Complications of CABG. Subjects and Methods: This study was carried out over 26 months (from oct 2006 until Jan 2009). Patients referred for CABG to a private hospital (n= 187) single clamp was used (group I), while patients referred to university hospital (n=187) were operated upon by conventional method of multiple clamps (group II). The incidence of cerebral injury that was clinically patients referred diagnosed in both groups were analyzed. Results: There were one left side hemiplegia and one mortality in group I and one left side hemiplegia and two cases of encephalopathy without any mortality in group II. Conclusion: The results of this study suggest that there is no benefit of single clamp over multiple clamp technique in terms of reduction in the incidence of stroke although there are some advantages of single clamp in causing less cognitive disorders. Sci Med J 2010; 9(5):435-439