Troponin as a marker of myocardial damage during coronary surgery with and without cardiopulmonary bypass

Background. The use of coronary surgery without cardiopulmonary bypass (CBP) has been growing during the last years. In order to compare myocardial damage during coronary surgery with and without CBP, perioperative Troponin T determinations were done. Methods. Experimental design and setting: prospective, comparative. Cardiovascular surgery department. Patients, interventions and measures: 29 prospective patients who underwent elective coronary surgery were enrolled. Troponin T determinations (ng/ml) were done before surgical procedure, after a 2-hour and after a 12-hour postoperative. Population was divided in two groups: group 1, with CBP (17 patients); group 2, without CBP (12 patients). Variables in relation with population characteristics, myocardial damage and immediate postoperative haemodynamic results were all analyzed. Results. Population characteristics and basal Troponin levels were similar for the two groups. Troponin T average levels at 2-hour postoperative period was 0.729 ng/ml and 0.067 ng/ml for group 1 and 2, respectively (p <0.00002). At 12 hours postoperative period Troponin T was 1.047 ng/ml and 0.183 ng/ml for group land 2 (p <0.0002). Haemodynamic performance was better in the group without CBP. Conclusions. Troponin T levels were significantly elevated in group 1, showing that surgical procedures without CBP caused less myocardial damage.