Perioperative management in minimally invasive coronary surgery

Pavie, Alain; Lima, Leonardo; Bonnet, Nicolas; Regan, Mary; Aktar, Rama; Gandjbakhch, I

doi:10.1093/ejcts/16.supplement_2.s53

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…IP and intracoronary shunts have been used to limit ischemic injury, but the use of the shunt in a vulnerable coronary artery may damage the endothelium. 13 IP has been considered to be a promising method for achieving myocardial protection, although controversial results concerning the effectiveness of IP also have been shown. 10,11,14,15 Reports on IP in patients undergoing off-pump CBP surgery are still few in number, and not all of those studies are even randomized.…”

mentioning

confidence: 99%

Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Laurikka

Iisalo

et al. 2002

Chest

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confidence: 99%

Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Laurikka

Iisalo

et al. 2002

Chest

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“…IP and intracoronary shunt has been used to avoid the ischemia. However, the insertion of the shunt to the plaques, calcification or tortuous artery would be difficult and might damage the endothelium [97]. Therefore, IP might be an ideal and effective method in achieving additional myocardial protection.…”

Section: Off-pump Cabg Patientsmentioning

confidence: 99%

Ischemic Preconditioning in Cardiac Surgery

Tarkka

2011

Int J Angiol

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Murry and colleagues in 1986 described a paradoxical phenomenon that exposure of the heart to repeated brief ischemic episodes delayed the severity of myocardial infarction of a following prolonged myocardial ischemia and termed it myocardial ischemic preconditioning (IP). From then on, IP had been extensively studied in various kinds of experimental models as well as in humans. Besides delaying myocardial infarction, IP has been proved to be a potent endogenous factor in preserving high energy phosphates, suppressing arrhythmias and improving postischemic functional recovery. Delaying myocardial ultrastructure damage, reducing lactate, reducing the utilization of myocardial glycogen and protecting coronary endothelium after IP has also been found. Different experimental models and conditions resembling cardiac surgery have also been investigated. The mechanism of IP is not yet clear, however. The conclusions derived from animal studies could not totally stand for the situation in open heart surgery. IP was found effective in preserving high energy phosphate, improving heart performance and decreasing cardiac troponin T release during open heart surgery. Controversial exists because in same reports there were no effects of IP. The difference in IP protocol, myocardial protective method and study object might be the reason of the controversial results. Several clinical factors may affect IP effects during clinical practice. The purpose of the present study was to review the recent literature on IP, especially the IP mechanism, IP phenomenon in cardiac surgery and the possible influential factors, to summarize whether IP might prefer additional protection of current protective strategy in cardiac surgery.

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Perioperative management in minimally invasive coronary surgery

Abstract: Some simple rules had to be applied to reduce the rate of complications to the minimum: a good clinical case selection, use of a routine protocol, and recognize the need to adapt the indications to the learning curve of the operator.

Cited by 2 publications

References 7 publications

Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Regional Ischemic Preconditioning Enhances Myocardial Performance in Off-Pump Coronary Artery Bypass Grafting

Ischemic Preconditioning in Cardiac Surgery

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