Background: Coronary artery bypass grafting is still a therapy of choice for complex ischemic heart disease. The purpose of the study was to compare the relation between obesity and blood flow through aorto-coronary bypass grafts with coexisting preoperative inflammatory state presented neutrophil-to-lymphocyte and platelets-to-lymphocyte ratios in retrospective analysis. Methods: We analyzed 50 consecutive patients (mean age 65 +/- 8) who underwent off-pump coronary artery bypass grafting (OPCAB) in our department in 2018. Graft blood flow measurements, as well as platelet-to-lymphocyte (PLR) and neutrophil-to-lymphocyte (NLR) ratios were evaluated. Results: Obese patients undergoing arterial revascularization were characterized by statistically significant lower arterial grafts flow for RIMA (p=0.0043), LIMA (p=0.0023) and RA (p=0.0214) with satisfactory medium term (897 +/- 123 days) results. The chronic inflammatory parameters including NLR and PLR were significantly differed between obese and non-obese patients (p=0.0312 and p=0.0003, respectively) referred for surgery. The inverse correlation between BMI and NLR (r=0.307) and PLR(r=0.413) was noted. Conclusion: Obese patients referred for CABG present a decreased graft blood flow velocity combined with an increased neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio.

Percutaneous coronary interventions (PCI) have an established position in the management of patients presenting with acute coronary syndromes and stable coronary artery disease with low complications rates. We present the case of a 67-year-old male referred for urgent coronary catheterization intervention with anterior wall ST-elevation myocardial infarction diagnosis. After stent implantation, the wires were removed however a part of the wire was entrapped in the coronary artery. The metallic coil covering the core of the angioplasty wire was left in proximal part of LAD and protruded into the aortic root. Patient was referred for emergency surgical procedure that was performed through median sternotomy in cardiopulmonary bypass (CPB) and moderate hypothermia. After transverse aortotomy, the foreign body of 7 cm in length was found irremovable, it was transected and left in the proximal portion of the left main coronary artery (LM). The decision to perform revascularization of LAD, CX and RCA was undertaken. The estimated graft blood flow measurements were satisfactory with the values of 7 mL/min in LIMA-to-LAD graft, 39 mL/min in SVBG-to-CX and 43 mL/min in SVBG-to-RCA, respectively. The patient’s postoperative course was uneventful. Cardiac surgery is a reasonable method of treatment in patients with coronary artery disease and PCI complicated with entrapment of broken guidewire protruding in aortic root.