| Coronary grafts flow and cardiac pacing modalities: how to improve perioperative myocardial perfusion. | |
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MedLine Citation:
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PMID: 15200984 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Aim of this study was to investigate modifications of coronary grafts flow during different pacing modalities after CABG. MATERIALS AND METHODS: Two separate prospective studies were conducted in patients undergoing CABG and requiring intraoperative epicardial pacing. In a first study (22 patients) coronary grafts flows were measured during dual chamber pacing (DDD) and during ventricular pacing (VVI). In a second study (10 patients) flows were measured during DDD pacing at different atrio-ventricular (A-V) delay periods. A-V delay was adjusted in 25 ms increments from 25 to 250 ms and flow measurements were performed for each A-V delay increment. A transit time flowmeter was used for the measurements. RESULTS: An average of 3.4 grafts/patient were performed. In the first study, average coronary graft flow was 47.4+/-20.8 ml/min during DDD pacing and 41.8+/-18.2 ml/min during VVI pacing (P = 0.0004). Furthermore average systolic pressure was 94.3+/-10.1 mmHg during DDD pacing and 89.6+/-12.2 mmHg during VVV pacing (P = 0.0007). No significant differences in diastolic pressure were recorded during the two different pacing modalities. In the second study, maximal flows were achieved during DDD pacing with an A-V delay of 175 ms (54+/-9.6 ml/min) and minimal flows were detected at 25 ms A-V delay (38.1+/-4.7 ml/min) (P=ns). No significant differences in systolic or diastolic blood pressure were noticed during the different A-V delays. CONCLUSION: Grafts flowmetry provides an extra tool to direct supportive measures such as cardiac pacing after CABG. DDD mode with A-V delay around 175 ms. should be preferred to allow for maximal myocardial perfusion via the grafts. |
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Authors:
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Giuseppe D'Ancona; Martin Hargrove; John Hinchion; B C Ramesh; Jehan Zeb Chughtai; Muhammad Nadeem Anjum; Aonghus O'Donnell; Tom Aherne |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 26 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-06-17 Completed Date: 2004-09-07 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 85-8 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, Cork University Hospital, Cork, Ireland. rgea@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Pacing, Artificial
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methods* Coronary Artery Bypass / methods* Coronary Circulation* Hemodynamics Humans Intraoperative Care / methods* Prospective Studies Vascular Patency* |
| Comments/Corrections | |
Comment In:
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Eur J Cardiothorac Surg. 2005 Jan;27(1):177-8; author reply 178
[PMID:
15621502
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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