Does intraaortic filtration capture particulate debris in OPCAB cases using anastomotic devices?
These data clearly suggest that there is no difference between the amount of particulate debris generated in OPCAB cases versus CPB cases. In OPCAB cases where an anastomosis device was used without a partial clamp, particulate debris may be reduced but not eliminated. These findings may demonstrate the importance of aortic manipulation, particularly clamping, as a source of particulate material in cardiac surgery. However, more study needs to be done to confirm these findings with a larger number of patients.
Undersized annuloplasty exacerbates leaflet tethering. Posterior leaflet augmentation with less severe annular reduction increases leaflet curvature and decreases tethering; this technique more completely addresses the pathogenic mechanism of IMR and may improve repair durability.