Myocardial Management in Arterial Revascularization

Allen, Bradley S.

doi:10.1007/3-540-30084-8_6

Cited by 3 publications

(2 citation statements)

References 46 publications

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“…13,14 Perioperative myocardial damage and dysfunction remain the most common causes of early and late cardiovascular events and mortality after technically successful CABG operations. 15,16 Optimal myocardial protection during onpump CABG may be obtained by minimizing the ischaemic time and providing an adequate, homogeneous distribution of cardioplegia solution to all myocardial segments. 17,18 Patients with CAD require effective delivery of cardioplegic solution beyond coronary stenoses or occlusions.…”

Section: Discussionmentioning

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

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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.

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Section: Discussionmentioning

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

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“…Hence, several improvements in cardioplegia delivery techniques have been made to improve myocardial preservation [ 8 , 9 ]. As there is a high probability of postoperative mortality in CABG due to myocardial dysfunction [ 10 , 11 ], myocardial protection during CPB can be achieved by providing adequate distribution of a cardioplegia solution throughout the myocardium [ 12 ]. Distribution of cardioplegia beyond the occluded coronary vessels effectively protects the myocardium [ 13 ].…”

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

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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.

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Effect of Hypoxia-Reoxygenation on Endothelial Function in Porcine Cardiac Microveins

Dong

Yim

et al. 2006

The Annals of Thoracic Surgery

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Myocardial Management in Arterial Revascularization

Cited by 3 publications

References 46 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

Effect of Hypoxia-Reoxygenation on Endothelial Function in Porcine Cardiac Microveins

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