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Right arrow Myocardial protection

Ann Thorac Surg 2003;75:S745-S752
© 2003 The Society of Thoracic Surgeons

III: Abstracts

Abstracts

John W. Hammon, Jr, MD1, Jakob Vinten-Johansen, PhD1

The first 300 words of the full text of this article appear below.

These abstracts were presented at the 3rd International Symposium on "Myocardial Protection From Surgical Ischemic–Reperfusion Injury" as a moderated poster session. They represent cutting-edge investigations into a wide range of areas related to the pathophysiology of myocardial ischemic-reperfusion injury and myocardial protection. It is the purpose of this portion of our supplement to use these superb investigations to stimulate further ideas and discussion of the topics presented here. Perhaps the novel information presented in these abstracts will provide stimulus for further research leading to innovative changes in the clinical practice of myocardial protection.

Myocardial preservation and pre-load recruitable stroke work relationships following off-pump and on-pump coronary revascularization

PV Ching, HB Bittner. Division of Cardiovascular and Thoracic Surgery, University of Minnesota, Minneapolis, MN

Background: It is shown that coronary artery bypass grafting (CABG) without cardiopulmonary bypass or CPB (off-pump or OPCABG) preserves better cerebro-cognitive, pulmonary, hepato-renal, and blood cell function compared to on-pump surgery due to an attenuated inflammatory response. The degree of ischemia/reperusion injury, myocardial protection as well as quantitative changes in myocardial contractile performance following OPCABG are not well documented.

Methods: A canine myocardial ischemic injury model (60 minutes LAD occlusion,n = 30,27 to 35 kg) was used to assess postoperative regional left ventricular function (sonomicrometry, micromanometry, preload-recruitable stroke work=PRSW) quantitatively,oxygenation, and inflammatory response(cytokines/adhesion molecules). The left internal thoracic artery (LITA) to distal LAD was anastomosed in off-pump/on-pump CABG with antegrade/retrograde cold blood cardioplegic arrest (CPB-time 58 minutes ± 2; cross clamp time 28 minutes ± 3). (ANOVA, t-test, *=p < 0.05 vs base line).

Results: LAD occlusion resulted in ischemia/infarction (CK-MB on-pump/off-pump vs base line 17.5 ± 1.4*/19.5 ± 1.8* mg/L vs 1.5 ± 0.3/2.1 ± 0.4) and a significant decrease in regional myocardial function in both groups (PRSW decrease by 50%, see Fig 1). Revascularization led to reestablishment of myocardial function to base line (on-pump/off-pump PRSW = 57 to . . . [Full Text of this Article]






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