| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2006;30:597-603
© 2006 Elsevier Science NL
a Department of Cardiac Surgery, Schüchtermann-Klinik Bad Rothenfelde, Ulmenallee 11, 49214 Bad Rothenfelde, Germany
b Department of Anesthesiology, Schüchtermann-Klinik Bad Rothenfelde, Germany
c Department of Anesthesiology, Medical University of Lübeck, Germany
d Institut für klinische und molekulare Herz-Kreislaufforschung der Universität Witten-Herdecke, Dortmund, Germany
e Department of Cardiac Surgery, University of Insubria-Varese, Germany
Received 25 December 2005; received in revised form 7 June 2006; accepted 26 June 2006.
* Corresponding author. Address: Department of Cardiac Surgery, Schüchtermann-Klinik Bad Rothenfelde, Ulmenallee 11, 49214 Bad Rothenfelde, Germany. Tel.: +49 5424 64130070. (Email: jochen.poeling{at}freenet.de).
Background: For the first time, microdialysis was used to investigate in vivo and online the myocardial metabolism during and after cardiac surgery in patients treated with two different methods of myocardial protection. Methods: Thirty patients underwent standard CABG with one of two different methods of myocardial protection. The patients were randomised to receive either cold blood (COLD group) or warm modified Calafiore cardioplegia (WARM group). Microdialysis probes were implanted into the myocardium of left ventricular apical region of the heart. Cardioplegia was given antegrade only. Microdialysis measurements were performed at time intervals before, during and 24 h after cardiopulmonary bypass and analysed for glucose, lactate, pyruvate and glycerol. Results: Myocardial lactate concentrations were significantly higher in the WARM group compared with that of the COLD group, while serum lactate was comparable. Glycerol was significantly higher at the end of the clamping time in the WARM group. At the same time the glucose–lactate ratio as a marker of nutritional disorder had significantly lower levels in the WARM group. The cumulative CK-MB release over 24 h was significantly higher in those hearts protected with warm blood. Conclusions: The oxidative stress measured was significantly higher in patients undergoing CABG using modified Calafiore cardioplegia, whereas the cold cardioplegia minimised the effects of aortic clamping. The results indicate that cold cardioplegia offers superior protection of the heart, in terms of more rapid normalisation of myocardial metabolism. In elective myocardial revascularisation, intermittent antegrade warm blood cardioplegia is a comparable safe method of myocardial protection. However, in patients referring to a long clamping time, advantages of cold cardioplegia for myocardial revascularisation may be magnified.
Key Words: Cardiovascular surgery • Cardioplegia • Energy metabolism • Glycolysis • Ischaemia
This article has been cited by other articles:
|
|
 |
|
  T. B. Albacker, R. Chaturvedi, A. H. Al Kindi, H. Al-Habib, T. Al-Atassi, B. de Varennes, and K. Lachapelle The effect of using microplegia on perioperative morbidity and mortality in elderly patients undergoing cardiac surgery Interactive CardioVascular and Thoracic Surgery, July 1, 2009; 9(1): 56 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ghazy, O. Allham, A. Ouda, U. Kappert, and K. Matschke Is repeated administration of blood-cardioplegia really necessary? Interactive CardioVascular and Thoracic Surgery, May 1, 2009; 8(5): 517 - 521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Pojar, J. Mand'ak, N. Cibicek, V. Lonsky, J. Dominik, V. Palicka, and J. Kubicek Peripheral tissue metabolism during off-pump versus on-pump coronary artery bypass graft surgery: the microdialysis study Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 899 - 905. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
