Graft Flushing Solution Applies Myocardial Protection Properties in Coronary Artery Bypass Grafting

Introduction: In on-pump coronary artery bypass grafting (CABG) procedures testing of the distal anastomoses via repeated flushing of graft storage solution perfuses at a certain extent the downstream myocardium. This study evaluated the impact of specific solutions on myocardial protection during CABG procedures. Hypothesis: Duragraft® (Somaluthion, Jupiter FL,USA) storage solution exhibits beneficial myocardial protection compared to 0.9% Saline/Biseko® (Biotest Pharma GmbH, Dreieich, Germany). Methods: Between 7/2019 - 3/2020 either Duragraft® (Group A) or 0.9% Saline/Biseko (Group B) was applied during 272 CABG procedures. After propensity matching 166 patients of identical group size (male: 86.7%; 68.1 ± 9.3 years) were analyzed in this single center retrospective study. Cardiac enzymes were evaluated after CABG during hospital stay and compared between both groups. Results: The mean count of venous and overall grafts was 1.5 (± 0.5) and 2.6 (±0.7). No clear difference in the distribution pattern of Creatine Kinase was observed, while high sensitive Troponin I (in nanogram per liter) were significantly lower in Group A at 12-24 hours (4384.9 (± 5509.6) vs. 11566.9 (± 31505,1); p= 0.042), two days (1931.9 (± 3079.8) vs. 4978.5 (± 9145.6); p= 0.05), three days (1473.3 (± 3207.4) vs. 2939.8 (±5564.5); p= 0.046) four days (992.4 (± 1957.3) vs. 1995 (± 3404.8); p= 0.037) and at the sixth day (716.3 (± 1056,2) vs. 1573.9 (±3013.1); p= 0.046) after surgery. Conclusions: Downstream myocardium perfusion with graft solution could provide enhanced myocardial protection in on-pump procedures, with Duragraft® being superior to Saline/Biseko® in terms of Troponin release.