Myocardial protection of different perfuse ways for cardioplegia in patients undergoing on-pump coronary artery bypass

doi:10.3969/j.issn.2095-4344.2015.07.023

Abstract

Abstract:

BACKGROUND: On-pump coronary artery bypass has better long-term effects than off-pump coronary artery bypass. For patients with severe coronary artery stenosis, antegrade perfusion simply via the aortic root is ineffective in myocardial protection, and how to get a good myocardial protection has become one of the key factors affecting the bypass effects.

OBJECTIVE: To compare the myocardial protection role of different perfuse ways for cardioplegia in the process of coronary artery bypass graft surgery under cardiopulmonary bypass.

METHODS: Twenty-three patients undergoing coronary artery bypass graft surgery were divided into three groups according to different perfuse ways: antegrade perfusion group, antegrade combined with graft cardioplegia perfusion group and antegrade combined with retrograde perfusion roup. Blood samples were taken to test the levels of serum cardiac troponin I, creatine kinase and MB isoenzyme of creatine kinase before operation, 30 minutes after the beginning of cardiopulmonary bypass, 5 minutes, 2 hours, 6 hours and 24 hours after reperfusion. The amount of vaso-active drugs, postoperative cardiac auto-rebeating rate, cardiopulmonary bypass time, myocardial ischemic time, extubation time and ICU stay time were recorded.

RESULTS AND CONCLUSION: The serum levels of cardiac troponin I were significantly lower in the cardioplegia perfusion and retrograde perfusion groups than that in the antegrade perfusion group after reperfusion 2 hour to 24 hours (P < 0.05). The levels of creatine kinase were significantly lower in the cardioplegia perfusion and retrograde perfusion groups after reperfusion 5 minutes to 24 hours (P < 0.05). The levels of MB isoenzyme of creatine kinase were significantly lower in the cardioplegia perfusion and retrograde perfusion groups after reperfusion 6 hours to 24 hours (P < 0.05). There were no significant differences in the postoperative cardiac auto-rebeating rate and the amount of vaso-active drugs used among the three groups. These findings indicate that antegrade combined with graft cardioplegia perfusion or antegrade combined with retrograde perfusion has better protective effects on the myocardium than antegrade coronary perfusion under cardiopulmonary bypass.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: Extracorporeal Circulation, Troponin I, Isoenzymes

CLC Number:

R318

Gao Guo-dong, Hu Qiang, Hu Jin-xiao, Duan Xin, Hei Fei-long, Yu Kun, Long Cun. Myocardial protection of different perfuse ways for cardioplegia in patients undergoing on-pump coronary artery bypass[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(7): 1112-1116.

Figures/Tables 3

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