Early Safety and Intraoperative Performance of An Intracoronary Shunt in Coronary Artery Bypass Grafting: A Multicenter Real-World Experience

Abstract

Background: Intracoronary shunts are used during coronary artery bypass grafting (CABG) to maintain distal coronary perfusion and facilitate distal anastomosis. As the device is removed intraoperatively, evaluation is mainly limited to short-term safety and procedural performance. Therefore, this multicenter real-world study assessed the early safety and operational effectiveness of the NAUTICA™ intracoronary shunt during CABG.

Methods: A retrospective observational  study  consists of 211 patients, who received CABG or Off-pump coronary artery bypass grafting (OPCABG) or CABG with valve surgery at two medical facilities. The NAUTICA™ intracoronary shunt was used during distal coronary anastomosis. The primary endpoints of the study were  major adverse cardiac and cerebrovascular events (MACCE) occurred within 30 days. While,  length of hospital stay, hemodynamic stability, anastomosis time  and device-related complications were secondary endpoints.

Results: The study consists of   211 patients (mean age 64.33 ± 9.54 years; 76.3% male) successful underwent shunt-assisted coronary anastomosis. The mean anastomosis time was 6.98 ± 1.41 minutes. Study reports no intraoperative myocardial infarctions, procedural failures, or shunt-associated complications. Hemodynamic was stable in all patients, with no ischemic changes on intraoperative electrocardiography. One in-hospital major adverse cardiac and cerebrovascular event (MACCE; 0.47%), corresponding to mortality due to acute congestive cardiac failure, was observed. No additional MACCE occurred during the 30-day follow-up.

Conclusion: The study shows a satisfactory intraoperative performance with stable hemodynamics of shunt during CABG. The outcomes of the study shows an acceptable short-term safety of shunt during coronary anastomosis.