Search Results
Results 451 - 500 of 1627
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Oshima Kiyohiro - - 2005
OBJECTIVE: We developed a new apparatus for long-term heart preservation that combines simple immersion with coronary perfusion. In a previous study, we reported that suppression of pro-inflammatory cytokines, such as tumor necrosis factor alpha (TNF-alpha) and interleukin-1beta (IL-1beta), improved results after transplantation. In this study, we evaluated whether long-term preservation ...
Coles James A JA - - 2005
INTRODUCTION: Myocardial edema is a clinically relevant problem found in post-ischemic reperfused hearts. The objective of this study was to understand the effects of hetastarch-supplemented cardioplegia on post-ischemic edema and cardiac function. MATERIALS AND METHODS: Swine hearts were arrested with either St. Thomas Hospital cardioplegia with (n=6) or without (n=7) ...
Rabkin David G - - 2005
BACKGROUND: The utility of combining strategies of myocardial protection was studied in intact rat hearts subjected to 1 hour of ischemia and 40 minutes blood reperfusion. METHODS: Lewis rats (n = 48) were divided into 4 transplant groups. Twenty-four hearts were arrested by coronary perfusion with hypothermic Celsior solution at ...
Pestel Gunther J - - 2005
PURPOSE OF REVIEW: Perioperative hypothermia triples the incidence of adverse myocardial outcomes in high-risk patients; it significantly increases blood loss and augments allogeneic transfusion requirements. Even mild hypothermia increases the incidence of surgical wound infection following colon resection and therefore the duration of hospitalization. Hypothermia adversely affects antibody- and cell-mediated ...
Badak Muharrem I - - 2005
The aims of this study were to evaluate myocardial metabolic activity during tepid blood cardioplegic infusion in the arrested heart in comparison with cold blood cardioplegia and to assess the early clinical outcomes of these patients. Thirty patients undergoing first elective coronary artery bypass grafting surgery were included and randomized ...
Feng Jun - - 2005
BACKGROUND: Alterations of microvascular reactivity reduce myocardial perfusion after ischemic cardioplegia. We hypothesized that bradykinin preconditioning (BKPC) would preserve endothelium-dependent microvascular responses and improve myocardial function after cardioplegic ischemia-reperfusion. METHODS: Rabbit hearts were perfused with Krebs-Henseleit buffer (KHB). The hearts were arrested for 60 minutes with moderately cold (25 degrees ...
Wakui Shinji - - 2005
BACKGROUND: In recent years, various beneficial roles of human atrial natriuretic peptide (hANP) have been demonstrated in the internal medicine and surgical fields. However, direct myocardial protection by hANP against myocardial ischemic reperfusion injury has been rarely investigated. Thus, we investigated it from aspects of cardiac surgery. METHODS: Twenty-four pigs ...
Hayashi Y - - 2005
AIM: The most effective delivery of blood cardioplegia (BCP) remains controversial, and a combination of initial continuous and intermittent bolus BCP seems to compensate each demerit. However, a large amount of crystalloid solution is infused into the myocardium in this method, which may nullify the advantages of BCP. We examined ...
Savini C - - 2005
BACKGROUND: Minimally invasive cardiac surgery (MICS) is a safe and satisfactory approach used mainly in mitral valve surgery with excellent results in many centers. Cardioplegia administration can be still a problem, especially when an endoaortic clamp is used. We retrospectively analyzed our early results with histidine-triptophane-ketoglutarate (HTK) solution used for ...
Law William R - - 2005
BACKGROUND: Specific site proteolysis and loss of troponin I (TnI) during myocardial ischemic events can contribute to myocardial dysfunction. Adenosine supplementation of cardioplegic solutions results in improved functional preservation of the heart. We investigated the effect of adenosine on N-terminal and C-terminal proteolysis of TnI in the heart. MATERIALS AND ...
Xiang Daokang - - 2005
The effects of L-carnitine, as an ingredient of cardioplegia solution, on cardiac function and cardiomyocyte apoptosis in patients undergoing heart valve replacement operation were investigated. Twenty-three cases undergoing heart valve replacement with cardiopulmonary bypass (CPB) were randomly allocated into two groups: L-carnitine group (n = 12, 12 g/L L-carnitine was ...
Guo Wei - - 2005
To find a better strategy for effective donor organ preservation, here we used a model of long-term hypothermia preservation of rat hearts to investigate the cardioprotective effects of diazoxide, a selective opener of mitochondrial ATP-sensitive potassium channel (mitoK<sub>ATP </sub>). Cardiac function was impaired by 8-hour ischemic preservation following 30 minutes ...
Ringe B - - 2005
BACKGROUND: In living donor liver transplantation (LDLTx) organ procurement is usually well controlled, and allows to assess liver preservation and graft function under standardized conditions. Because publications on histidine-tryptophan-ketoglutarate (HTK) solution are limited, we prospectively studied its safety and efficacy in a consecutive series of LDLTx. METHODS: Twenty-four patients received ...
Selldén E - - 2005
BACKGROUND: In abdominal surgery and in healthy volunteers, amino acids increased thermogenesis. In this double-blind study we investigated if a similar effect would ensue in heart surgery and accelerate the rewarming process postoperatively. METHODS: Thirty-four patients undergoing coronary artery bypass grafting or aortic valve replacement were randomized into two groups, ...
Øvrum Eivind - - 2004
OBJECTIVES: A large number of experimental studies have indicated that blood cardioplegia might be superior to crystalloid cardioplegia for myocardial protection during ischemic arrest. However, no prospectively randomized studies of large patient series have been undertaken to prove potential differences in clinical course. METHODS: Over a 52-month period, all patients ...
Dobson Geoffrey P - - 2004
Cardiac surgery continues to be limited by an inability to achieve complete myocardial protection from ischemia-reperfusion injury. This paper considers the following questions: (1) what lessons can be learned from mammalian hibernators to improve current methods of human myocardial arrest, protection and preservation? and (2) can the human heart be ...
Bernard M - - 2004
Long duration ischemia in hypothermic conditions followed by reperfusion alters membrane transport function and in particular Na,K-ATPase. We compared the protective effect of two well-described cardioplegic solutions on cardiac Na,K-ATPase activity during reperfusion after hypothermic ischemia. Isolated perfused rat hearts (n = 10) were arrested with CRMBM or UW cardioplegic ...
Karthik S - - 2004
OBJECTIVE: To identify current myocardial protection strategies for coronary artery bypass grafting (CABG) across the UK and Ireland. METHODS: A questionnaire survey of 15 questions was sent to practising cardiac surgeons between June and October 2002. The list of surgeons was obtained from the Society of Cardiothoracic Surgeons of Great ...
Kumbhani Dharam J - - 2004
OBJECTIVE: To determine the impact of regional myocardial acidosis encountered during cardiac surgery on the need for inotropic and intra-aortic balloon (IAB) support. METHODS: Intramyocardial tissue pH(37C) was measured in 247 patients undergoing cardiopulmonary bypass (CPB). Inotropic support (INO) was defined as requiring one or more of norepinephrine/epinephrine/amrinone/dobutamine/>2.5 mug/kg/min dopamine, ...
Ryugo Masahiro - - 2004
BACKGROUND: In heart transplantation, myocardial apoptosis during hypothermic storage contributes to graft dysfunction. On the other hand, hepatocyte growth factor (HGF) has been reported to be an antiapoptotic factor in the heart. Therefore, we assessed whether the administration of recombinant human HGF (rh-HGF) prevents apoptosis in the prolonged preserved myocardium, ...
Khan Tanveer A - - 2004
BACKGROUND: Surgical coronary revascularization with cardiopulmonary bypass and cardioplegia has been associated with reperfusion injury. The serine protease inhibitor aprotinin has been suggested to reduce reperfusion injury, yet a clinically relevant study examining regional ischemia under conditions of cardiopulmonary bypass and cardioplegia has not been performed. METHODS: Pigs were subjected ...
Kiziltepe Ugursay - - 2004
OBJECTIVE: Endothelial dysfunction with decreased nitric oxide (NO) levels has been implicated on reperfusion injury. Although L-arginine has been shown to diminish reperfusion injury in in vitro studies, clinical studies were very limited. METHODS: Forty patients with acute myocardial ischemia undergoing CABG were randomized to a study and a control ...
Yamazaki Kazuhiro - - 2004
OBJECTIVE: Cardioplegic arrest remains the method of choice for myocardial protection in cardiac surgery. Poly(adenosine 5'-diphosphate-ribose) synthetase (PARS) inhibitor has been suggested to attenuate the ischemia-reperfusion injury in myocardial infarction by preventing energy depletion associated with oxidative stress. We investigated the efficacy of a cardioplegic solution containing a PARS inhibitor, ...
Resatoglu Adem Grbolar - - 2004
BACKGROUND: The calcium-channel blocking effect of magnesium might have protective effects in patients undergoing cardiopulmonary bypass surgery. We assessed the effects of magnesium on hearts undergoing coronary artery bypass surgery with intermittent warm blood hyperkalemic cardioplegia in the antegrade fashion. PATIENTS AND METHODS: Twenty patients undergoing coronary bypass surgery were ...
Bloomfield Eric L - - 2004
We evaluated the safety, pharmacokinetics, and pharmacodynamics of diaspirin cross-linked hemoglobin (DCLHb) solution in patients after repair of abdominal aortic aneurysm. We performed a randomized, single-blind controlled study with 10 patients in the surgical intensive care unit of a tertiary care facility. Within 24 hours after repair of an abdominal ...
Simkhovich Boris Z - - 2004
BACKGROUND: Our laboratory demonstrated that mild regional hypothermia reduced myocardial infarct size by an average of 65% in the rabbit model of regional ischemia. The exact mechanism for this benefit has not been explored. We hypothesized that a moderate reduction in regional myocardial temperature could preserve cardiac energy metabolism and ...
Brat R - - 2004
AIM: This study was done to evaluate a myocardial function in the early hours after coronary artery bypass grafting (CABG) in patients with left ventricular dysfunction and to compare blood and crystalloid cardioplegia. METHODS: One hundred consecutive patients with left ventricular ejection fraction <35% scheduled for CABG were randomly divided ...
Scheule Albertus M - - 2004
BACKGROUND: Organ shortage limits the number of transplantations, and donor deterioration may precede and often prevent conventional organ preservation. This study evaluates in situ perfusion as a bedside method for cardiac allograft procurement in a large animal model. METHODS: Thirty Landrace pigs (42 +/- 7 kg) were studied. The hearts ...
Faggian G - - 2004
AIM: To evaluate safety and efficacy of blood cardioplegia in a retrospective selected (but not randomized) donor/recipient population as standard organ preservation technique in high-risk heart transplants (HTX). MATERIALS AND METHODS: The rationale of different strategies was based on both donor and recipient evaluations. Unstable donors with a long history ...
el-Hamamsy I - - 2004
AIM: Sanguineous (blood) cardioplegia has been established as the prime option for myocardial protection but the choice of dilution (4:1 blood to crystalloid ratio) versus use of blood from the cardiopulmonary bypass alone (minicardioplegia) remains controversial. The purpose of this prospective randomized clinical trial was to compare the clinical outcome ...
Palatianos George M - - 2004
BACKGROUND: We tested the hypothesis that depletion of neutrophil leukocytes from the cardioplegic and the initial myocardial reperfusion perfusates reduces clinical indices of reperfusion injury in patients undergoing elective coronary artery bypass. METHODS: We studied 160 consecutive patients who underwent standard coronary revascularization with cardiopulmonary bypass. Patients with recent myocardial ...
Dobson Geoffrey P - - 2004
OBJECTIVE: Depolarizing potassium cardioplegia has been increasingly linked to left ventricular dysfunction, arrhythmia, and microvascular damage. We tested a new polarizing normokalemic cardioplegic solution employing adenosine and lidocaine as the arresting, protecting, and preserving cardioprotective combination. Adenosine hyperpolarizes the myocyte by A1 receptor activation, and lidocaine blocks the sodium fast ...
Li Shu - - 2004
Myocardial protection through different cardioplegia approaches is an important issue for successful cardiovascular surgery. The objective of this prospective randomized study was to evaluate the effect of myocardial protection of warm (37 degrees C) and cold (6 degrees C) cardioplegic induction, respectively, using a Langendorff isolated rat heart perfusion model. ...
Svenarud P - - 2004
BACKGROUND: The risks that the presence of air microemboli implies in open-heart surgery have recently been emphasized by reports that their number is correlated with the degree of postoperative neuropsychological disorder. Therefore, we studied the effect of CO2 insufflation into the cardiothoracic wound on the incidence and behavior of microemboli ...
Nemoto Shintaro - - 2004
Carnitine is an essential cofactor for fatty acid (FA) metabolism, the predominant source of ATP in the normal aerobic heart. During myocardial ischemia, FA metabolism is impaired and tissue carnitine levels are depleted. Since the heart cannot synthesize carnitine, plasma carnitine could play an important role in maintaining myocardial carnitine ...
Klass Oliver - - 2004
BACKGROUND: Pharmacologic Na(+)/H(+) exchange inhibition has been suggested to ameliorate cardiac performance depression associated with myocardial ischemia/reperfusion. The purpose of our experimental study was to investigate the impact of the novel Na(+)/H(+) exchange inhibitor Eniporide (EMD 96785) on cardiac performance and high energy phosphate content in a clinically relevant pig ...
Louagie Yves A G - - 2004
BACKGROUND: To assess the influence on myocardial protection of the rate of infusion (continuous vs intermittent) of cold blood cardioplegia administered retrogradely during prolonged aortic cross-clamping. The end-points were ventricular performance and biochemical markers of ischemia. METHODS: Seventy patients undergoing myocardial revascularization for three-vessel disease were prospectively randomized to receive ...
Stefanutti Giorgio - - 2004
BACKGROUND/PURPOSE: Multiple organ failure subsequent to intestinal ischaemia and reperfusion (I/R) includes cardiac failure, but little is known about heart energy metabolism in this setting. This study investigates the effects of intestinal I/R on heart energy metabolism and evaluates the effects of moderate hypothermia. METHODS: Adult rats underwent intestinal ischaemia ...
Kuhn-Régnier Ferdinand - - 2004
BACKGROUND: Coronary oxygen persufflation (COP) has been shown to prolong heart preservation time up to 14 hr in a mature pig model, with excellent recovery after orthotopic transplantation. The aim of the present study was to assess the structural, metabolic, and functional myocardial and endothelial integrity after COP in mature ...
Fischer Jürgen H - - 2004
OBJECTIVE: The use of non-heart-beating donors (NHBD) might increase the number of grafts available for transplantation. Experiments on heart transplantation from NHBDs demonstrated the necessity for oxygenation during preservation to allow sufficient myocardial recovery. It has been shown that, after 16 min normothermic ischemia followed by 3.3-h hypothermic preservation, excellent ...
Allen Bradley S - - 2004
This article describes the experimental infrastructure and subsequent successful clinical application of a comprehensive cardioplegic strategy that limits intraoperative injury and improves postoperative outcomes in pediatric patients. The infant heart is at high risk of damage from poor protection as a result of preoperative hypertrophy, cyanosis, and ischemia. These factors ...
Arslan Caner - - 2004
This study was designed to determine the effects of pretransplant ischemic hypothermic period on reactivities of major coronary arteries. Eleven pigs were used. Right, left anterior descending and circumflex coronary arteries harvested from 6 pigs following single dose of cardioplegia and cardiectomy. The same procedures were performed in 5 pigs ...
Yaliniz Hafize - - 2004
BACKGROUND: Although the present techniques of myocardial preservation for limiting ischemia/reperfusion injury in open heart operations yield excellent results for most patients, certain subgroups of patients with advanced coronary artery disease present a challenge in terms of intraoperative safety. METHODS: In a prospective, randomized, controlled study, we assessed the myocardial ...
Nicolini Francesco - - 2003
Current techniques of myocardial protection are evolving with the use of less conventional modalities of cardioplegia and have reduced the morbidity and mortality of cardiac operations. Blood cardioplegic solutions appear superior to cold cardioplegia in terms of myocardial protection and adjuncts as glutamate/aspartate enhancement, antioxidant supplementation, nitric oxide donors and ...
Olivencia-Yurvati Albert H - - 2003
OBJECTIVES: To determine whether pyruvate-fortified cardioplegia solution provides cardioprotection superior to lactate-based cardioplegia solutions in patients undergoing elective coronary revascularization, with specific attention to post-surgical recovery of left ventricular performance as well as biochemical markers of ischemic injury. DESIGN: Prospective, randomized, semi-blinded human trial. SETTING: Community-based academic medical center. PARTICIPANTS: ...
Kabon Barbara - - 2003
Hypothermia is common during anaesthesia and surgery owing to anaesthetic-induced inhibition of thermoregulatory control. Perioperative hypothermia is associated with numerous complications. However, for certain patient populations, and under specific clinical conditions, hypothermia can provide substantial benefits. Lowering core temperature to 32-34 degrees C may reduce cell injury by suppressing excitotoxins ...
Alex Joseph - - 2003
The objective of this study was to compare the immediate post-operative outcome of two myocardial protection strategies. Data of consecutive elective first time coronary artery bypass grafting (CABG) were analysed: Group A (n=671, antegrade-retrograde cold St Thomas blood cardioplegia) and Group B (n=783, intermittent cross-clamp fibrillation). Age, angina class, myocardial ...
Doufas Anthony G - - 2003
Perioperative hypothermia triples the incidence of adverse myocardial outcomes in high-risk patients. Mild hypothermia significantly increases blood loss and augments allogeneic transfusion requirement, but the molecular pathophysiology of this effect remains to be elucidated. Only 1.9 degrees C core hypothermia triples the incidence of surgical wound infection following colon resection ...
Hayashi Yoshitaka - - 2003
OBJECTIVES: This study was designed to examine the myocardial protective effect of leukocyte-depleted terminal blood cardioplegia in association with nitric oxide and peroxynitrite production, especially for patients undergoing prolonged aortic crossclamping. METHODS: Fifty-four patients (34 men, 20 women, mean age 56.7 +/- 12.7 years) undergoing aortic valve replacement were randomly ...
Baron Olivier - - 2003
OBJECTIVE: Three myocardial protection techniques were evaluated in a prospective, randomised trial during coronary artery bypass grafts in 69 patients. MATERIAL AND METHOD: Twenty seven patients received intermittent hyperkalaemic undiluted warm blood anterograde cardioplegia (AC), 21 received continuous hyperkalaemic undiluted warm blood retrograde cardioplegia (RC) and 21 received intermittent, hyperkalaemic, ...
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