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Titolo:
Postoperative myocardial ischemia in thoracic aortic aneurysms
Autore:
Sasaki, S; Yasuda, K; Nanzaki, S; Kobayashi, S; Morimoto, Y; Gando, S; Kemmotsu, O;
Indirizzi:
Hokkaido Univ Hosp, Div Intens Care, Dept Cardiovasc Surg, Kita Ku, Sapporo, Hokkaido 0608648, Japan Hokkaido Univ Hosp Sapporo Hokkaido Japan 0608648 Hokkaido 0608648, Japan
Titolo Testata:
JOURNAL OF CARDIOVASCULAR SURGERY
fascicolo: 3, volume: 42, anno: 2001,
pagine: 333 - 338
SICI:
0021-9509(200106)42:3<333:PMIITA>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAJOR VASCULAR-SURGERY; CARDIAC MORBIDITY; NONCARDIAC SURGERY; CYTOKINES; RISK; INTERLEUKIN-8; COMPLICATIONS; REPERFUSION; MANAGEMENT; PREDICTORS;
Keywords:
aortic aneurysm, thoracic, surgery; myocardial ischemia; postoperative complications; blood vessel prosthesis implantion; cardiopulmonary bypass;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Sasaki, S Hokkaido Univ Hosp, Div Intens Care, Dept Cardiovasc Surg, Kita Ku, N-14,W-5, Sapporo, Hokkaido 0608648, Japan Hokkaido Univ Hosp N-14,W-5 Sapporo Hokkaido Japan 0608648 Japan
Citazione:
S. Sasaki et al., "Postoperative myocardial ischemia in thoracic aortic aneurysms", J CARD SURG, 42(3), 2001, pp. 333-338

Abstract

Background. To determine the incidence and predictors of postoperative myocardial ischemia in non-coronary risk patients undergoing surgery for thoracic aortic aneurysms. Methods. Design: a prospective, observational study. Setting: a general intensive care unit in a university hospital. Participants: twenty patients without ischemic heart disease, scheduled for elective surgical repair of thoracic or thoracoabdominal aortic aneurysms. Interventions: all patients underwent aortic replacement with prosthetic graft and routine postoperative care. Patients who developed myocardial ischemia received an infusion of coronary vasodilators. Results. ECG episodes of myocardial ischemia were defined as reversible ST-segment changes of either >1 min of depression or >2 min of elevation at the J point. All patients survived operation. Eleven patients (ischemia group) developed myocardial ischemia, and 9 patients did not (non-ischemia group). These episodes were transient in 8 cases, but lasted longer than 3 daysin 3 cases. In univariate analysis of perioperative factors between the two groups, the use of total cardiopulmonary bypass (p<0.01), the cardiac index at ICU admission (P<0.05), and the incidence of preexistent hypertension(P<0.05) were significantly different. Multiple regression analysis identified the use of total cardiopulmonary bypass as the only predictor of myocardial ischemia. Conclusions. The use of total cardiopulmonary bypass is predictive of perioperative myocardial ischemia in surgery for thoracic aortic aneurysms, probably due to the production of proinflammatory cytokines by systemic ischemia and reperfusion. Prophylactic use of coronary vasodilators may be validated in these cases.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 08/04/20 alle ore 07:26:30