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The Annals of Thoracic Surgery, Vol 33, 139-144, Copyright © 1982 by The Society of Thoracic Surgeons
HG McDaniel, JG Reves, NT Kouchoukos, LR Smith, WJ Rogers, PN Samuelson and WA Lell
Fifty patients undergoing isolated coronary artery bypass grafting
procedures using a clear, cold cardioplegic solution, topical hypothermia,
and reduced systemic flow for intraoperative myocardial protection were
evaluated for myocardial injury by serial plasma creatine kinase-MB
isoenzyme (CK-MB) measurements and electrocardiograms. Forty-one (82%) of
the patients had three-vessel disease. Preoperative left ventricular
contractility determined angiographically was normal in 13 patients (26%),
mildly abnormal in 26 (52%), and moderately or severely abnormal in 11
(22%). The number of arteries grafted ranged from 2 to 6 (mean, 3.5). The
mean duration of aortic clamping was 38.6 +/- 1.6 minutes. There were no
hospital deaths. Enzymatic and electrocardiographic (ECG) evidence of
myocardial infarction occurred in 1 patient. Nonspecific ECG changes
occurred in 16 patients (32%), and th electrocardiograms were unchanged in
the remaining 33 patients (66%). In the 49 patients without ECG evidence of
infarction, the mean peak plasma CK-MB value, which occurred 6 hours after
the onset of cardiopulmonary bypass, was 7.9 +/- 0.8 IU/L (standard error
of the mean) and the mean integrated area 158 +/- 19.5 IU/L X hours. There
was no correlation between these CK-MB values and the extent of disease,
number of arteries grafted, or the duration of myocardial ischemia. These
data document a low incidence of perioperative myocardial injury with this
technique, and can serve as a baseline for comparison with other techniques
for intraoperative myocardial protection in this setting.
ARTICLES
Detection of myocardial injury after coronary artery bypass grafting using a hypothermic, cardioplegic technique
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A. M. Fabricius, W. Gerber, M. Hanke, J. Garbade, R. Autschbach, and F. W. Mohr Early angiographic control of perioperative ischemia after coronary artery bypass grafting Eur. J. Cardiothorac. Surg., June 1, 2001; 19(6): 853 - 858. [Abstract] [Full Text] [PDF] |
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