Effect of cardiopulmonary bypass on tissue injury markers and endothelial activation during coronary artery bypass graft surgery

Nair, Suresh; Iqbal, Khalid Javed; Phadke, Milind; Jadhav, Uday; Khandekar, Jayant; Khandeparkar, Jagdish

doi:10.4103/0022-3859.93246

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…It is widely used to determine perioperative myocardial injury after cardiac surgery and is an important indicator of the recovery of cardiac function and prognostic risk factors [19,20]. The present study has shown that the extent of myocardial injury after thoracoscopicASD repair was significantly lower than after conventional surgery, which is a prerequisite for the successful rehabilitation of patients who undergo cardiac surgery.…”

Section: Discussionmentioning

confidence: 49%

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

Liu

Zhu

et al. 2014

Eur J Med Res

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BackgroundTo compare the effect of totally thoracoscopic with conventional, open repair of atrial septal defect.MethodsForty atrial septal defect cases were divided into two groups by surgical approach: totally thoracoscopic approach (group A, n = 20) and conventional open approach (group B, n = 20). In group A, surgical procedures were performed through three portal incisions in the right lateral chest wall under thoracoscopic vision without the aid of a computerized robotic surgical system. Notably, all operations were completed by one surgeon who had just begun using this technique. In group B, the atrial septal defects were repaired in conventional open fashion. Clinical outcomes and serum levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), intercellular adhesion molecule 1 (ICAM-1), and creatine kinase isoenzyme-myocardial band (CK-MB) for the two groups were evaluated and compared.ResultsAll operations were performed successfully without serious complications. Durations of cardiopulmonary bypass (CPB), CPB setup, aortic cross-clamping, and operative procedure were significantly longer in group A than in group B (P < 0.05). The recovery times for body temperature and laboratory values of leukocytes were significantly shorter for group A than for group B (P < 0.05). There were no differences in durations of postoperative assisted ventilation or intensive care unit and hospital stays, volumes of blood transfused intraoperatively or thoracic drainage, or medical costs between the two groups. Serum levels of inflammatory factors (TNF-α, IL-6, IL-10, and ICAM-1) and CK-MB increased significantly in both groups after surgery. However, 6 h and 12 h after surgery, levels of these inflammatory factors and CK-MB were significantly lower in group A than in group B (P < 0.05).ConclusionsThoracoscopic cardiac surgery is technically feasible and safe, with less trauma and quicker recovery even when done by a surgeon newly introduced to the technique.

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Section: Discussionmentioning

confidence: 49%

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

Liu

Zhu

et al. 2014

Eur J Med Res

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“…Research has shown that the large pressure drop and shear stress across oxygenators in CPB is associated with hemolysis, leukocyte activation, and other inflammatory processes . This may be a significant cause of tissue injury via endothelial activation, increased neutrophil‐mediated cytotoxicity, or other factors . In this experiment, the Medos Deltastream DP3 exhibited a slightly greater pressure drop across the oxygenator, which may suggest a marginal increased risk of tissue injury.…”

Section: Discussionmentioning

confidence: 70%

In Vitro Comparison of the Delivery of Gaseous Microemboli and Hemodynamic Energy for a Diagonal and a Roller Pump During Simulated Infantile Cardiopulmonary Bypass Procedures

et al. 2013

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Cardiopulmonary bypass (CPB) is used for a variety of procedures in pediatric patients. Flow settings of the CPB pump have dramatic effects on patient outcome, and gaseous microemboli delivery within the CPB circuit has been linked to neurological complications. To ensure the ongoing improvement of pediatric CPB, consistent evaluation and improvement of the equipment is necessary. In this study we analyze the Jostra HL-20 roller pump (Jostra USA, Austin, TX, USA) and a Medos Deltastream DP3 diagonal pump (MEDOS Medizintechnik AG, Stolberg, Germany) which has not yet received Food and Drug Administration approval. An infant CPB model with heparinized human blood is used to quantify the gaseous microemboli delivery (via an Emboli Detection and Classification Quantifier), as well as the hemodynamic energy delivered under flow rates of 400, 800, and 1200 mL/min. Results show that at most flow settings the DP3 delivers fewer microemboli than the Jostra roller pump at the pre-oxygenator site, with an exception at 1200 mL/min under pulsatile mode. The total volume and the number of gaseous microemboli greater than 40 μm in diameter were lower in the DP3 group. The HL-20 exhibits less stolen blood flow (except at 1200 mL/min) and oxygenator pressure drops in both pulsatile and nonpulsatile mode. Additionally, under pulsatile flow the DP3 delivers greater surplus hemodynamic energy. Both pumps produce relatively few microemboli and deliver adequate hemodynamic energy to the pseudo-patient, with the DP3 performing slightly better under most flow settings.

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“…В настоящее время известно, что операция в условиях искусственного кровообращения негативно влияет на эндотелиальную функцию [12]. К специфическим факторам хирургической агрессии в условиях искусственного кровообращения относятся контакт крови с чужеродной поверхностью контуров аппарата искусственного кровообращения, хирургическая травма, ишемически -реперфузионные повреждения, изменения температуры тела, вызывающие развитие системного воспаления [13].…”

Section: Discussionunclassified

The Influence of Coronary Bypass on Endothelial and Erectile Dysfunction in Ischemic Heart Disease

Помешкина¹,

Помешкин²,

Sergeeva³

et al. 2015

Russ J Cardiol

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Цель. Оценка влияния коронарного шунтирования в условиях искусственного кровообращения на эндотелиальную и эректильную дисфункцию у больных ишемической болезнью сердца (ИБС). Материал и методы. В исследовании учувствовало 117 мужчин со стабильной ИБС в возрасте 55,8±5,3 лет, планирующихся на КШ. У всех пациентов для проведения обследования использовались: опросник "Международный индекс эректильной функции" (МИЭФ), регистрация ночных пенильных тумисценций (НПТ), посткомпрессионные тесты на плечевой и кавернозных артериях. Все пациенты были разделены на две группы: с наличием эректильной дисфункции (ЭрД) (n=60) и группу без ЭрД (n=57). Результаты. По результатам исследования у пациентов с ЭрД операция коронарного шунтирования (КШ) в условиях искусственного кровообращения значительно ухудшила эректильную функцию. Оказалось, что наличие ЭрД перед операцией является важным прогностическим фактором ее прогрессирования после операции. Пациенты же с ненарушенной эректильной функцией после операции имели высокую вероятность сохранения ее качества. Более того, оказалось, что у пациентов без предоперационной ЭрД к 6 месяцам после КШ отмечалась тенденция к улучшению показателей ЭЗВД по сравнению с исходными показателями, а в группе пациентов с ЭрД такой положительной динамики не отмечалось. Кроме того, у пациентов без ЭрД на всех этапах обследования сохранялись достоверно лучшие показатели вазорегулирующей функции эндотелия плечевой артерии по сравнению с пациентами с ЭрД. Такая же тенденция сохранялась и при анализе эндотелиальной функции на кавернозных артериях. При анализе различий в частоте возникновения в течение года после КШ сердечно-сосудистых событий выяснилось, что в группе с ЭрД у четырех (7%) больных развились различные сердечно-сосудистые события, в то время как у пациентов без ЭрД этих событий отмечено не было. Заключение. Таким образом, наличие ЭрД может быть важным маркером неблагоприятного течения заболевания у пациентов с ИБС, подвергшихся КШ.

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Effect of cardiopulmonary bypass on tissue injury markers and endothelial activation during coronary artery bypass graft surgery

Cited by 8 publications

References 25 publications

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

Totally thoracoscopic repair of atrial septal defect reduces systemic inflammatory reaction and myocardial damage in initial patients

In Vitro Comparison of the Delivery of Gaseous Microemboli and Hemodynamic Energy for a Diagonal and a Roller Pump During Simulated Infantile Cardiopulmonary Bypass Procedures

The Influence of Coronary Bypass on Endothelial and Erectile Dysfunction in Ischemic Heart Disease

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