A Technique for Selective Graft Perfusion During Aortocoronary Bypass

Goldman, Bernard S.; Ovil, Yoel; Mycyk, Taras

doi:10.1111/j.1540-8191.1987.tb00206.x

Cited by 6 publications

(5 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17,18 Patients with CAD require effective delivery of cardioplegic solution beyond coronary stenoses or occlusions. 2,3 In the present study the technique used was similar to the method that Goldman et al 19 described in 1987. The version of the MT Goncu, M Sezen, F Toktas et al…”

Section: Discussionmentioning

confidence: 98%

“…This technique can also supply blood to the ischaemic myocardium during construction of the proximal graft anastomosis, promoting early reperfusion and rapid recovery of grafted ischaemic myocardial regions, which may decrease ischaemia time. Goldman et al 19 suggested that selective graft perfusion provides early and appropriate cooling of the most ischaemic zones identified by either electrocardiographic changes or intramyocardial temperature probes, and allows warm blood reperfusion during construction of the proximal anastomosis. These researchers concluded that the technique may be applicable to patients who present with acute ischaemia and evolving infarction, failed angioplasty, or left main coronary artery stenosis.…”

Section: Antegrade Graft Cardioplegia Plus Passive Graft Perfusion In On-pump Cabgmentioning

confidence: 99%

See 1 more Smart Citation

Effect of Antegrade Graft Cardioplegia Combined with Passive Graft Perfusion in On-Pump Coronary Artery Bypass Grafting

Goncu

Sezen²,

Toktaş³

et al. 2010

J Int Med Res

View full text Add to dashboard Cite

Patients undergoing on-pump coronary artery bypass graft (CABG) with proximal graft anastomosis were randomly divided into groups that received antegrade cardioplegic infusion only via the aortic root (group A) or antegrade cardioplegic infusion via the aortic root and additional cardioplegia via vein or free arterial grafts after completion of each distal anastomosis (group B). The group B patients also received bypass graft perfusion with warm arterial blood just after removal of the cross-clamp until the proximal graft anastomosis was completed. The need for defibrillation and inotropic support during separation from cardiopulmonary bypass (CPB), and total CPB time were significantly lower in group B than in group A. Group B also had significantly lower peak cardiac troponin I levels 12 h after operation compared with group A and this was more pronounced in subgroups with severe right coronary artery stenosis and poor left ventricular ejection fraction than in the whole population. It is concluded that antegrade graft cardioplegia and graft perfusion with warm blood during proximal graft anastomosis may improve myocardial protection.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Antegrade Graft Cardioplegia Plus Passive Graft Perfusion In On-pump Cabgmentioning

confidence: 99%

Effect of Antegrade Graft Cardioplegia Combined with Passive Graft Perfusion in On-Pump Coronary Artery Bypass Grafting

Goncu

Sezen²,

Toktaş³

et al. 2010

J Int Med Res

View full text Add to dashboard Cite

show abstract

“…This study method was nearly identical to the method suggested by Goldman et al, which stated that careful graft perfusion provides appropriate cooling of the most ischemic zones to protect myocardium by reperfusion of cold blood cardioplegia. The researchers concluded that this method is suitable for patients who present with acute ischemia, failed angioplasty, left main occlusion, and LV systolic dysfunction [15]. Until now, not many studies have been done on cardioplegia through vein grafts to protect the myocardium.…”

Section: Discussionmentioning

confidence: 99%

Cardio-Protective Effects of Multiport Antegrade Cold Blood Cardioplegia Versus Antegrade Cold Blood Cardioplegia in Patients With Left Ventricular Systolic Dysfunction Undergoing Conventional Coronary Artery Bypass Grafting

Ali¹,

Moeen²,

Paras³

et al. 2020

Cureus

View full text Add to dashboard Cite

Introduction The aim of this study was to compare the in-hospital outcomes of multiport antegrade cold blood cardioplegia through vein grafts versus conventional antegrade cold blood cardioplegia in patients with left ventricle systolic dysfunction who underwent coronary artery bypass grafting (CABG). Methods This prospective, randomized clinical study was comprised of patients undergoing on-pump CABG at the Ch. Pervaiz Elahi Institute of Cardiology in Multan, Pakistan from November 18, 2018 to December 17, 2019. Patients with multivessel coronary artery disease and left ventricular systolic dysfunction (ejection fraction < 50%) were included. In Group A (N = 73), multiport antegrade cold blood vein graft cardioplegia was given after every distal anastomosis completed for myocardial preservation. In Group B (N = 73), conventional antegrade cold blood cardioplegia was given for myocardial preservation. Results Spontaneous rhythm (without defibrillation applied) after cross-clamp removal was higher in Group A than in Group B (93.3% vs. 85.2%, p < 0.05). Duration of support, ventilation time, and hospital stay were also significantly lower in Group A than in Group B with p = 0.00001, p = 0.03, and p = 0.002, respectively. Intra-aortic balloon pump insertion (4.1% vs. 23.0%, p = 0.02) and operative mortality (0.5% vs. 4.0%, p = 0.35) were also lower in Group A than in Group B. Postoperative left ventricular ejection fraction (LVEF) increased more in Group A than in Group B, and the postoperative LVEF mean value was 44.68% in Group A versus 41.26% in Group B (p = 0.02). Conclusion Multiport vein graft blood cardioplegia provides superior myocardial protection in patients with left ventricular systolic dysfunction who underwent CABG. It is also easy to administer, so this technique can be adopted as a routine method for myocardial protection in patients with left ventricular dysfunction planned for on-pump CABG.

show abstract

“…Homogeneous perfusion of all heart segments may be limited in poorly collateralized coronary artery stenosis cases when only aortic delivery is performed [16][17][18]. In such cases, subsequent dosing, as in the blood cardioplegia protocol, particularly when antegrade graft perfusion is available, provides appropriate cooling of the most ischemic zones and may improve the outcome [19][20]. However, we did not notice any difference in favour of blood cardioplegia in our cohort, which is a similar finding to other reports on using the del Nido protocol in high-risk cases [21][22].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Determinants of Inadequate Cardioprotection in Adult Patients with Left Ventricular Dysfunction

Sanetra

Gerber

Buszman

et al. 2023

Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Background: Perioperative cardioprotection is essential for achieving satisfactory clinical outcomes in heart failure patients. It is important to understanding the factors affecting perioperative cardioprotection. Methods: The institutional database was searched for patients with reduced ejection fraction (EF, < 40%) who underwent surgery with cardioplegia-induced arrest. Patients were divided into del Nido cardioplegia (DN) and cold blood cardioplegia (CB) groups. The relationships between age, preoperative blood parameters, creatinine, cross-clamp time (CCT), extracorporeal circulation time (ECT), and postoperative troponin values at 12 h or deterioration of EF (≥ 5%) were evaluated. Baseline characteristics, operative parameters, and outcomes were analyzed. Results: There were 508 patients with reduced EF (331 DN and 177 CB). In the entire cohort, anaemic patients had greater troponin values (p = 0.004), as well as in the DN group (p = 0.002). However, this was not detected in the CB group (flat regression line; p = 0.674). Patients with high leukocyte values had greater troponin release (entire cohort: p < 0.001; DN group: p < 0.001; CB group: steep regression line with p = 0.042). Longer CCT and ECT were associated with greater troponin release (entire cohort; both groups) and greater risk of fall in EF. In a direct comparison, fewer patients had significant deterioration of EF in the DN group than CB group (3.9% vs 11.9%; p < 0.001). Conclusions: The use of CB cardioplegia may be beneficial in anaemic patients, while the use of DN cardioplegia may be beneficial for expected long CCT and high leucocytosis.

show abstract

A Technique for Selective Graft Perfusion During Aortocoronary Bypass

Cited by 6 publications

References 5 publications

Effect of Antegrade Graft Cardioplegia Combined with Passive Graft Perfusion in On-Pump Coronary Artery Bypass Grafting

Effect of Antegrade Graft Cardioplegia Combined with Passive Graft Perfusion in On-Pump Coronary Artery Bypass Grafting

Cardio-Protective Effects of Multiport Antegrade Cold Blood Cardioplegia Versus Antegrade Cold Blood Cardioplegia in Patients With Left Ventricular Systolic Dysfunction Undergoing Conventional Coronary Artery Bypass Grafting

Determinants of Inadequate Cardioprotection in Adult Patients with Left Ventricular Dysfunction

Contact Info

Product

Resources

About