HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Harold L. Lazar Patrick Treanor Richard J. Shemin Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lazar, H. L. Articles by Shemin, R. J. Search for Related Content PubMed PubMed Citation Articles by Lazar, H. L. Articles by Shemin, R. J.

Ann Thorac Surg 1994;57:663-668
© 1994 The Society of Thoracic Surgeons

---

Articles

Enhanced recovery of ischemic myocardium by combining percutaneous bypass with intraaortic balloon pump support

Department of Cardiothoracic Surgery, The University Hospital and Boston University Medical Center, Boston, Massachusetts USA

Accepted for publication May 26, 1993.

^_* Address reprint requests to Dr Lazar, Department of Cardiothoracic Surgery, B404, The University Hospital, 88 E Newton St, Boston, MA 02118.

Although percutaneous bypass (PB) can support the failing myocardium, regional ischemic damage may still occur beyond a coronary occlusion. This study sought to determine whether the addition of intraaortic balloon pump (IABP) support to PB would result in more optimal salvage of ischemic myocardium. In 30 pigs, the second and third diagonal vessels were occluded with snares for 90 minutes followed by 30 minutes of cardioplegic arrest and 3 hours of reperfusion with the snares released. During the period ot coronary artery occlusion, 10 pigs were placed on PB, 10 pigs received PB plus IABP support, and 10 pigs received no support (the unmodified group). The hearts treated with the combination of PB and IABP support exhibited the highest wall motion scores (3.3 ± 0.20 for the PB plus IABP group (p < 0.05 from the unmodified group and from the PB group]; versus 1.40 ± 0.30 for the PB group versus 1.37 ± 0.33 for the unmodified group), the least tissue acidosis (change in pH, -0.30 ± 0.2 for the PB plus IABP group [p < 0.05 from the PB group] versus -0.60 ± 0.10 for the PB group versus -0.41 ± 0.13 for the unmodified group], and the least area of necrosis (25% ± 5% for the 13 plus IABP group [p < 0.05 from the unmodified group and from the PB group]; versus 43% ± 2% for the PB group [p < 0.05 from the unmodified group] versus 73% ± 3% for the unmodified group). We conclude that IABP support should be added to PB to obtain the most optimal results during surgical revascularization of acutely ischemic myocardium.

This article has been cited by other articles:

				R. John, K. Liao, K. Lietz, F. Kamdar, M. Colvin-Adams, A. Boyle, L. Miller, and L. Joyce Experience with the Levitronix CentriMag circulatory support system as a bridge to decision in patients with refractory acute cardiogenic shock and multisystem organ failure J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 351 - 358. [Abstract] [Full Text] [PDF]

				N. G. Smedira, N. Moazami, C. M. Golding, P. M. McCarthy, C. Apperson-Hansen, E. H. Blackstone, and D. M. Cosgrove III Clinical experience with 202 adults receiving extracorporeal membrane oxygenation for cardiac failure: Survival at five years J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 92 - 102. [Abstract] [Full Text] [PDF]

				A. Geppert, B. Frey, H. Gabriel, C. Kratochwill, and P. Siostrzonek Effects of Intraaortic Balloon Pumping on Coronary and Carotid Flow During Percutaneous Cardiopulmonary Support Ann. Thorac. Surg., May 1, 1996; 61(5): 1539 - 1541. [Abstract] [Full Text]

				G. W. Laub, S. Muralidharan, J. Reibman, J. Fernandez, W. A. Anderson, J. Gu, C. Daloisio, L. B. McGrath, and L. J. Mulligan ESMOLOL AND PERCUTANEOUS CARDIOPULMONARY BYPASS ENHANCE MYOCARDIAL SALVAGE DURING ISCHEMIA IN A DOG MODEL J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 1085 - 1091. [Abstract] [Full Text]

				D. D. Muehrcke, P. M. McCarthy, R. W. Stewart, R. C. Foster, D. A. Ogella, J. A. Borsh, and D. M. Cosgrove III Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock Ann. Thorac. Surg., February 1, 1996; 61(2): 684 - 691. [Abstract] [Full Text]

				D. D. Muehrcke, P. M. McCarthy, R. W. Stewart, S. Seshagiri, D. A. Ogella, R. C. Foster, and D. M. Cosgrove Complications of extracorporeal life support systems using heparin-bound surfaces: The risk of intracardiac clot formation J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 843 - 851. [Abstract] [Full Text]

				H. L. Lazar, P. Treanor, S. Rivers, S. Bernard, and R. J. Shemin Combining percutaneous bypass with coronary retroperfusion limits myocardial necrosis Ann. Thorac. Surg., February 1, 1995; 59(2): 373 - 378. [Abstract] [PDF]