Lecithinized superoxide dismutase (L-SOD) has a higher affinity for cell membranes than recombinant human superoxide dismutase has. The purpose of this study, is to evaluate the protective effects of L-SOD against ischemia/reperfusion injury in blood-perfused isolated rat heart subjected to 30-min global normothermic ischemia. Fifteen isolated hearts were divided into three groups: group I (n=5), the untreated control group, group II (n=5) received 3,000 units of L-SOD administered into the perfusion circuit at the beginning of reperfusion, and group III (n= 5) received 3,000 units of L-SOD administered into the perfusion circuit 10min after reperfusion. Left ventricular developed pressure, maximum positive and negative dp/dt, coronary vascular resistance and myocardial water content were assessed in each group. The percent recovery of left ventricular developed pressure in group II was significantly higher than that in group I and The percent recovery of maximum positive dp/dt in group II was significantly higher than that III, p<0.01). The percent recovery of maximum negative dp/dt in group II was also significantly resistance or myocardial water content among the three groups. These results suggest that L-SOD administered at the time of reperfusion has protective effects against ischemia/reperfusion injury in the isolated rat heart.

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Background: The preferred surgical revascularization strategy for patients with acute coronary syndromes and multivessel coronary artery disease is uncertain. We evaluated the outcomes of patients with acute coronary syndrome and multivessel disease managed with coronary artery bypass grafting (CABG). Methods and Results: Between April 2007 and August 2014, 111 patients underwent emargency CABG with acute coronary syndrome. Of those, 92 patients had multivessel disease. Early postoperative outcome was evaluated. Eighty-five patients (92.4%) underwent off-pump CABG and 7 (7.6%) on-pump CABG. Sixty-seven (72.8%) required IABP. The mean number of anastomoses was 3.3±0.9 per patient. All patients received complete revascularization. Thirty-four (37%) underwent with all arterial grafts. There ware two operative death (2.2%) in this study group. Conclusion: We suggest that off-pump CABG can be performed safely and effectively in selected patients with acute coronary syndrome requiring emergency coronary revascularization.

Studies have shown that postoperative disseminated intravascular coagulopathy（DIC）occurs in some patients with cardiac disease, acute aortic dissection, and ruptured abdominal aortic aneurysm. The specific pathophysiology of DIC in these settings are related to low cardiac function, shock, infection and sepsis as well as activation of coagulation cascade in the aneurysm sac or dissected aorta. A soluble form of recombinant human thrombomodulin（rhsTM）was approved in 2008 for the treatment of DIC. This report describes the safety and efficacy of rhsTM for the treatment of DIC in patients with cardiovascular disease operated in our department. Between October 2010 and March 2012, 35 patients with postoperative DIC were treated with rhsTM. Diagnosis of DIC was based on the diagnostic criteria for DIC of the Japanese Association for Acute Medicine（JAAM). During the first 6 months of the study period, after a diagnosis of DIC was made, the patients were treated with gabexate mesilate and antithrombin III, and if patients showed no improvement with conventional treatment, they received rhsTM for 6 days. During the last 10 months of the study period, patients received rhsTM soon after a diagnosis of DIC was made. Twenty seven patients survived for 28 days after rhsTM treatment, and the mortality rate was 22.9%（8/35). Patients who survived showed improvement in acute phase DIC scores, FDP levels, D-Dimer, fibrinogen and platelet counts during rhsTM treatment, but no improvement was observed in patients who died. No serious adverse events were found up to 28 days after the start of rhsTM administration. In conclusion, this study showed no adverse events of rhsTM, and further studies are needed to confirm that rhsTM administration is an effective therapeutic modality in the management of DIC after cardiovascular surgery.

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