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Titolo:
Experimental off-pump coronary artery revascularization with adenosine-enhanced reperfusion
Autore:
Muraki, S; Morris, CD; Budde, JM; Velez, DA; Zhao, ZQ; Guyton, RA; Vinten-Johansen, J;
Indirizzi:
Emory Univ, Sch Med, Carlyle Fraser Heart Ctr, Div Cardiothorac Surg, Atlanta, GA USA Emory Univ Atlanta GA USA rt Ctr, Div Cardiothorac Surg, Atlanta, GA USA
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 3, volume: 121, anno: 2001,
pagine: 570 - 579
SICI:
0022-5223(200103)121:3<570:EOCARW>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
REDUCES INFARCT SIZE; BEATING HEART; INTRACORONARY ADENOSINE; MYOCARDIAL PROTECTION; BYPASS-SURGERY; CANINE MODEL; INJURY; RECEPTOR; ISCHEMIA; BLOOD;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Vinten-Johansen, J Cardiothorac Res Lab, 550 Peachtree St NE, Atlanta, GA 30365 USA Cardiothorac Res Lab 550 Peachtree St NE Atlanta GA USA 30365
Citazione:
S. Muraki et al., "Experimental off-pump coronary artery revascularization with adenosine-enhanced reperfusion", J THOR SURG, 121(3), 2001, pp. 570-579

Abstract

Objective: Although beating heart coronary artery bypass grafting has recently gained popularity, it eliminates the protective strategies tie, cardioplegia) developed for use in conventional cardiac operations. We recently introduced the technique of perfusion-assisted direct coronary artery bypassto perfuse the grafted vessels during multivessel off-pump coronary arterybypass grafting. In the present study we tested the hypothesis that intracoronary reperfusion with the cardioprotective agent adenosine during simulated perfusion-assisted direct coronary artery bypass attenuates reperfusioninjury. Methods: In anesthetized dogs the heart was exposed, and the left anteriordescending coronary artery was ligated for 75 minutes. Reperfusion was achieved through a catheter in the left anterior descending coronary artery bymeans of a computer-controlled pump. Intracoronary left anterior descending coronary artery perfusion pressure was continuously matched to mean arterial blood pressure. In one group (adenosine group) 10 mu mol/L adenosine was added to the blood during the first 30 minutes of reperfusion, whereas another group (vehicle group) received a comparable volume of saline solution. Results: During the first 30 minutes of reperfusion, blood flow through the left anterior descending coronary artery was significantly greater (P < .05) in the adenosine group than in the vehicle group (150.6 <plus/minus> 21.9 vs 50.2 +/- 11.3 mL/min at 15 minutes of reperfusion). Although there were no group differences in postischemic wall motion, infarct size was significantly smaller in the adenosine group than in the vehicle group (11.1% +/- 3.0% vs 28.0% +/- 4.0% of area at risk, P < .05). Myeloperoxidase activity in the necrotic tissue, an index of neutrophil accumulation, tended to belower in the adenosine group than in the vehicle group (58.6 <plus/minus> 14.2 vs 91.0 +/- 21.6 Delta AbsUnits . min(-1) . g(-1) tissue). In isolatedpostischemic left anterior descending coronary artery rings, the maximal relaxation response to the endothelium-dependent vasodilator acetylcholine was significantly greater in the adenosine group than in the vehicle group (97.9% +/- 5.6% vs 64.7% +/- 6.5%, P < .05). Conclusion: This novel reperfusion strategy for off-pump coronary artery bypass grafting can be used not only in cases requiring multiple grafting but also to attenuate necrosis and endothelial dysfunction in acute evolving infarction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 19:43:32